|
4 - .2011 -252;,
<br />4 -2-012 - 1.32
<br />AC40RDr CERTIFICATE OF LIABILITY INSURANCE
<br />CATE(MM,9aIY,
<br />YY2/25/21115
<br />_
<br />0
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMP RTANTi If the certificate holder is an ADDITIONAL INSURED, the polioy(iesj must be endorsed. If SUBROGATION IS WAIV£D, subject to
<br />the terms and conditions of the policy, certain pcllcies may regUIN I an endorsement. A statement on this cartlflcets does not senior rights to the
<br />certificate holder In lieu of such endosemont s). )
<br />—;ROD
<br />UU.ER
<br />IN MEAei at., 9r Bill
<br />SL 3,naUranea 74aaOCidtaa Intl
<br />P1{QNE 408-776 -5800 _���,y��008 -776 8602
<br />NC No
<br />275 Tennant Ave, Suite 207
<br />EMAIL bill0alinsure,eom
<br />ADDRESS.
<br />an ll
<br />Morgan Bill, CA 95037
<br />_....__. ...._
<br />- ^,.,- _INSURER2 A. 01ieIN13COVE.RAGE _.,, _ „_ , +^
<br />.._...,.
<br />NAIC9
<br />2 000,000
<br />PREMI5E9 (Ea ec. urr noel
<br />Raztfovd
<br />321298
<br />msuRRO. 949- 542 -7996
<br />INeORaRS; sartford Casualty Ina. Co
<br />37978
<br />Pacific Services Inc
<br />IN6UR €RO
<br />gvlaa /zaxa
<br />dbal pacific Datacom
<br />INSURER O:
<br />927 Calle. Nagooio Ste Z
<br />____.__ _._._ .- ....._....._.____.._.____.._.
<br />......_..__....
<br />son Clemente, CA 92673
<br />IHSURRR E:.._..... —.__
<br />ISOMER F:
<br />1
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE. LISTED BELOW 'RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXC W SIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />LTR
<br />LL
<br />TYPE OF INSURANCE
<br />NER
<br />VNO
<br />— __-- - -� -
<br />PQLICY NUMBER
<br />- UO FF
<br />MMIBOMYY
<br />! POODYEXP
<br />MMIDCIYYYY
<br />LIMITS
<br />GENERALLlAB10'M
<br />i
<br />EACH EACH OCCURRENCE
<br />2 000,000
<br />PREMI5E9 (Ea ec. urr noel
<br />FS
<br />18 300,000
<br />>•
<br />COp9MERCIAL GENERAL L
<br />s
<br />r
<br />B 4031343323
<br />ovlaa /sous
<br />gvlaa /zaxa
<br />/IgBILITY
<br />... J CLAIM8 MADE CYI OCCUR
<br />'
<br />nD E%P,(AnYOne Pereo
<br />'
<br />1
<br />j
<br />I
<br />�_PERSDNAL &FlbV INJURY
<br />S 2 OG0 DOQ
<br />_...._ _._� __ _— — ...........I
<br />i GEHERALAGGREOATE
<br />$ 4,900,000,
<br />OEN'L AGGREGATE LIMIT APPLIES PER
<br />j
<br />PRODUCTSCOMPIOPAGG
<br />$ 9, OOfl,000
<br />PRO- rT
<br />-- ..-- --- - -__�.
<br />__._..._._..._...._,___.^
<br />POLIGY LOS
<br />I
<br />LAUTOMO.JLE LIAftTY
<br />I
<br />'
<br />�
<br />MEI SIN LELIMII
<br />—
<br />i DDD DDD
<br />_
<br />n
<br />ANY AUTO
<br />Y
<br />IB 4032349329
<br />Oi /s0/ans
<br />0a/ae/veae
<br />60e0rJde_
<br />POILY INJURY leer person)
<br />$
<br />ALL OWNED SCHEDULED
<br />j
<br />I
<br />- " °
<br />' 3001LY 1NJURY(Peoe dam}
<br />"-
<br />S
<br />AUTOS AUTOS
<br />NDN -0VI'NEO
<br />HIREDAUTOS I - AUTOS�LP-
<br />I
<br />gracErtl nJAMAGE
<br />Is
<br />WAS I OCCUR
<br />I
<br />EACH OCCURRENCE
<br />S
<br />�OMBRELLA
<br />! "Mcia)WAR I j CLAIM6 -AVIDB
<br />I
<br />4 gGIiRECATE
<br />$
<br />4
<br />' DED RETENTIONS
<br />!
<br />8
<br />WORKERS COMPENSATION
<br />OffF-
<br />P
<br />ANa EMPLOYERS'WiBILRY YIN
<br />ANYPRDpRIEYORMARYNERlE %ECUTIVE
<br />i
<br />j
<br />I
<br />I— .IORYI,T ER
<br />I EL EACH ACCIDENT
<br />_._.,.
<br />$ 1,000,000
<br />orri IMEMeER 5XCLUD507 CINtAI
<br />Y
<br />57RECES7871
<br />oifos /zoos
<br />0voa /zoos
<br />L._t
<br />_
<br />INATmAo'jq NH)
<br />I
<br />I_E L. EA EMPLb_YEE
<br />5 1,000,000
<br />Ifyyeb, daaniGe UPI.,
<br />DESCRIPTIONOPOPERATIONSbPIow
<br />I
<br />E.L DISEASE- PbLICY LIMITS
<br />-- —
<br />1, 000, 000
<br />i
<br />OESORIPTION OF OPERATIONS I LOCATIONS I VLHICLES (Attach ACORD Un, Additional Rmmerks S¢hedmg R mare mmoa la raquiretl)
<br />As it psrtains to its California operations, and where required by contract for any and all locations for
<br />that contract, the following is 'nomad as additional insured interest.
<br />The City of Santa Ana, 20 Civics Center Plaza, Santa Ana, Ca, 92701, its officers, employees, agents,
<br />voluntawra and representatives with regard to Liability and defense of StUlta arising from the operations
<br />and uses performed by or en behalf 03! the named insured.
<br />CERTIFICATEHOLDER CANCELLATION
<br />01 888- 2010ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2010106) The ACORD nameand logo are registerad marks of ACORD eFj1 ��
<br />x 113
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />The City of Santa Ana.
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />,20 Civic Confer Plaza
<br />Santa Ana, CA 92703.
<br />AUTHORIZED REPRESENTATIVE
<br />01 888- 2010ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2010106) The ACORD nameand logo are registerad marks of ACORD eFj1 ��
<br />x 113
<br />
|