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BAUTISTA, SANTIAGO-2015
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BAUTISTA, SANTIAGO-2015
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DATE IMM /DD /1 <br />� <br />A a" CERTIFICATE OF LIABILITY INSURANCE 1 89/12/2014 <br />PRODUCER <br />Mettle Insurance Agency, Inc. <br />27101 Puena Real Spire 200 <br />Mellon Viejo, CA 92E91- <br />977.438,7459 <br />INSURED <br />Santiago Bautista <br />1523 W 6th St <br />Santa Ana, CA 92703- <br />COVERAGES <br />THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br />INSURER 0'. <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NSR <br />LTR <br />AOW1 <br />PER) <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE IMM /DD /YYYYI <br />POLICY EXPIRATION <br />DATE IMM /OD /YYVY) <br />LIMITS <br />A <br />X <br />GENERALLIABILITY <br />TXPRC MMERCIAL GENERAL LIABILITY <br />CLAIMS MADE I--] OCCUR <br />FESS IONAL LIABILITY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY PROJECT LOG <br />PHPKI096454 <br />001 <br />30/11/2014 <br />10111/2015 <br />EACH OCCURENCE <br />$1,000,010 <br />PREMISES Ea occrence <br />$100,000 <br />MEDEXP(Anyone person) <br />$2,500 <br />PERSONAL &ADVHUURY <br />$1,000,000 <br />GENERAL AGGREGATE <br />$3,000,000 <br />PRODUCTS- COMP /OPAGG <br />$3,000,000 <br />AUTOMOBILE <br />LIABILITY <br />ANV AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON-OWNED AUTOS <br />COMBINED SINGLE LIMIT <br />EA accldentl <br />BODILY INJURY <br />(Per perapnI <br />BODILY INJURY <br />(Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />GARAGE <br />LIABILITY <br />ANY AUTO <br />AUTO ONLY - EA ACCIDENT <br />OTHER THAN EA ACC <br />AUTO ONLY: AGG <br />EXCESS / UMBRELLA LIABILITY <br />OCCUR 1:1 CIAIMSMADE <br />DEDUCTIBLE <br />RETENTION <br />EACH OCCURENCE <br />AGGREGATE <br />Sily <br />a Cuevas <br />EMPLOYEHSLIABILITVTION ANO Y N <br />ANY PROPRLTDR /PARTNER EXECUTIVE <br />OFFICER /MEMBER EXCLUDED <br />(Mandatory In NH) <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />pRCSA/Admin <br />TORVTLIMITS LR <br />E.L. EACHACCIDENT <br />E.L. DISEASE - EA AMPLOYEE <br />E.L. DISEASE - POLICY OMIT <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />It Is understood end agreed that the Following entity Is added as an additional Insured but Drill wld, respoat(s( to the opeaBom of Hie named Insured except that liability resulting from tire additional In.sured's sole <br />negllgence. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />20 Chic Center <br />Santa Ana, CA 92701- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE <br />THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 11 DAYS WRITTEN NOTICE TO THE <br />CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 50 SHALL IMPOSE NO OBLIGATION OR <br />LIAR RITY OF ANY KI NO UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />ACORD 25 (2009/01) © 1988 -2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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