|
---°^� INTEHOU -03 VPXKERURKAR
<br />CERTIFICATE OF LIABILITY INSURANCE DATE(M 1b/15/25 /2 Y4
<br />014
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(es) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />PRODUCER License # 0726293 NAMfit y _
<br />4rthpr J. Gallagher..& Co_tnsuranca Brokers of CA., Inc, PHONE (818) 539 -2300
<br />INSURED
<br />Interval House
<br />P.O. Box 3356
<br />Soil Beach, CA 00740
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />CMfi[ZitI]
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />TYPE OF INSURANCE
<br />m L
<br />AUTHORIZED REPRESENTATIVE
<br />POLICY NUMBER I MiLQ0=
<br />MAVDD EXP
<br />LIMITS
<br />ERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE_ is
<br />1,000,000
<br />OCCUR
<br />X
<br />RIC0014071 1010112014
<br />1010112015
<br />pREntiSES Ea occurr ce
<br />S� 100,00
<br />MEDEXP(Anyooepason)
<br />$ 5,00
<br />Liab.
<br />lalAi)tSa
<br />ZGERLASCRECATE
<br />PERSONAL &ApVINJURY
<br />$ 1,000,00
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />LIMITAPPLIES PER:
<br />PRO - Y` JJECTOC
<br />PRODUCTS- COMP(OPAGG
<br />.$ 3,000,000
<br />R;
<br />$
<br />ILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />E2 accldenf
<br />ANY AUTO
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILYINJURY(Peraccldent)
<br />$ �~
<br />PROPfR- TnDAMAGE
<br />_
<br />$
<br />NON
<br />GOWNED
<br />HIRED AUTOS
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,00
<br />A FRI
<br />EXCESS Lwe
<br />CLAIMS-MADE
<br />RELOO14072 1010112014
<br />1010112015,
<br />AGGREGATE
<br />$
<br />DED X I RETENTION$ 0
<br />Ag T@ ate
<br />$` 2,000,00
<br />wORKBRSCOMPENSAT'ob
<br />JP
<br />)( STATUTE FRH
<br />ANO EMPLOYERS' LIABILITY
<br />B ANYPROPRIETORIPARTNEWEXECUTIVE Y❑
<br />WC201000005078 0210112014
<br />02I01I2015
<br />E.L EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatary in NH)
<br />NfA
<br />E.L. . DISEASE- EAEMPLCYE�
<br />$ 1,000,000
<br />If yye9 of softe under
<br />DESG�RIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 11000,000
<br />A Crime /Employee Theft
<br />RIC0014071 10/0112014
<br />10/0112015
<br />Deductible: $1,000 300,000
<br />A Forgery & Alteration
<br />RIC0014071 10/01/2014
<br />10/01 /2015
<br />Deductible: $1,000 200,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 10TAdditional Remarks Schedule, maybe attached If more apace is required)
<br />Contract # 2012.050. City of Santa Ana, its officers, agents, employees and volunteers are named additional insured with respect to the General Liability
<br />policy of the named Insured. Such insurance Is primary and noncontributory. CG2026 Endorsement attached.
<br />1
<br />Carrier A: Blanket Building Coverage Llmlt: $4,330,2001 Special Farm t Deductible $1,0001 effective 10.01.2014 to 10.01.2015 „(
<br />Carrler A: Blanket Business Contents Limit: $530,0001 Special Form t Deductible $1,0001 effective 10,01 -2014 to 10- 01.2015
<br />}
<br />C'ERTIFICATF HOLDER CANCELLATION
<br />O 1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered . marks of ACORD
<br />SHOULD ANY OF THIS ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City f Santa Ana, Administrative Services Division
<br />Y
<br />Attu; Terri Eggers
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza, M -25
<br />AUTHORIZED REPRESENTATIVE
<br />Santo Ana, CA 92701
<br />4'Lvi {,,y,ph,.L.n.,e
<br />O 1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered . marks of ACORD
<br />
|