Laserfiche WebLink
OP ID: RJ <br />CERTIFICATE OF LIABILITY INSURANCE <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />DATE 012015YI <br />0 4/1 012 01 5 <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 />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCERCONTACT <br />Phone: 858.457-5720 <br />NAME: <br />Rubin Insurance Agency Inc. Fax: 858.457-5729 <br />6363 Greenwich Dr, #120 <br />CA#0645355 San Diego, CA 92122 <br />Michael Rubin <br />PHONE <br />AIC No Ext: AIC No): <br />ADDRESS: <br />PRODUCER <br />CUSTOMER D k: B&DTO-1 <br />INSURERS AFFORDING COVERAGE NAIC N <br />INSURED B&D Towing, Inc <br />INSURERA:Insurance Company of the West 27847 <br />Balcaceras and Davalos Towing <br />1502 N Susan Street <br />INSURER B: <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F7 OCCUR <br />Santa Ana, CA <br />INSURER 0: <br />INSURER D: <br />INSURER E : <br />ny one person) $ <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INTR <br />L <br />TYPE OF INSURANCE <br />ADD <br />IMSEL <br />SU <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYV <br />POLICY EXP <br />MMIDDIYYYYW <br />LIMITS <br />GENERAL LIABILITY <br />RRENCE $ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F7 OCCUR <br />RE <br />Ea occurrence $ <br />ny one person) $ <br />&ADV INJURY $ <br />GGREGATE <br />GEN'L AGGREGATE LIMITAPPLIES PER: <br />CCMPIOP AGG 5 <br />POLICY �ETPRO LOC <br />5 <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ <br />(Ea accident) <br />ANY AUTO <br />BODILY INJURY (Per person) $ <br />ALL OWNED AUTOS <br />BODILY INJURY (Per accident) $ <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />PROPERTY DAMAGE <br />(Per accident) $ <br />$ <br />NON -OWNED AUTOS <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DEDUCTIBLE <br />$ <br />S <br />RETENTION $ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNERIEXECUTIVE YIN <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />NIA <br />X <br />WSD502471101 <br />10101/2014 <br />10/01/2015 <br />X TWO STATU- OTH- <br />S ER <br />E.L. EACH ACCIDENT $ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L DISEASE -POLICY LIMIT 1 $ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) <br />Proof of insurance. Waiver of subrogation endorsement WC990637(5-0 <br />applies. <br />CERTIFICATE HOLDER CANCIELLATION <br />CITYSA <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />60 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />Michael Rubin <br />ACORD 25 (2009109) <br />© 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />