|
123485
<br />CERTIFICATE, OF LIABILITY INSURANCE
<br />DATE (MMIDDJYYYY)
<br />10/26/2015
<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(ies) 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 />PRODUCER CONTACT
<br />NAME:
<br />Commercial Lines - (415) 541 -7900 PHONE
<br />tALQ fAQ f&U;___,_.__ -�
<br />Wells Fargo Insurance Services USA,. Inc. - CA Lic#: OD08408 E -MAIL
<br />ADDRESS:
<br />45 Fremont Street, Suuke $00 INSURER(S) AFFORDING COVERAGE NAIC #
<br />San Francisco, CA 94105 -2259 INSURER A: ACE American Insurance Company j 22667
<br />INSURED _ INSURER B. ACE Property and Casualty Ins. Co 1 20699
<br />ABM Onslte Services —West, Inc. _
<br />INSURER C;
<br />an ABM Industries Incorporated Company - -.— _._ _.......... _...__._ -_
<br />INSURER D ;
<br />1775 The Exchange SE, Suite 600 INSURER E:
<br />Atlanta, GA 30339 INSURER F ;
<br />rnVPanr:FC r I=RTIFIC'ATF NUMRFR- 9722820 REVISION NUMRER� See below
<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 />INSR . -_.
<br />LTR '.� TYPE OF INSURANCE
<br />AD DL SU 3_R
<br />I
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MMIDDfYYYY
<br />LIMITS
<br />A X
<br />COMMERCIAL GENERAL LIABILITY
<br />XS LG2.7401028
<br />11/01/2015
<br />11/01/2016
<br />EACH OCCURRENCE S 2,000 000
<br />....
<br />CLAIMS -MADE X OCCUR
<br />6 "I •
<br />C7AVAC TO RENTED
<br />PREMISES Ea occurrence S 2,Q09 QflQ
<br />X
<br />$1,000 000 SIR
<br />v ed
<br />y d� 6:a'+'
<br />� �
<br />MED EXP (Any one person) S Excluded
<br />_..._...,.......
<br />L.m. XCU
<br />PERSONAL 8 AOW VNJURY S 2.000.000
<br />GEN "L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE S 4,000,000
<br />PRO
<br />X POLICY JECT LOC
<br />_.....
<br />rr9� V r�
<br />_
<br />PRODUCTS - COMPIOP AGG 15 _ 2.OQfl.(7flQ
<br />_
<br />y
<br />Il4 Ok
<br />OTHER:
<br />A,
<br />AUTOMOBILE LIABILITY
<br />11/01/2015 11/01/2016 COMBINED SINGLE LIMIT j $ 6,000,000
<br />Ea ancidenL,
<br />14�� ---, It
<br />X ANY AUTO tl
<br />BODILY INJURY (Per person) j S
<br />x ALL OWNED SCHEDULED
<br />BODILY _...
<br />BODILY INJURY (Per aecpdent) $
<br />AUTOS AUTOS
<br />X NON -OWNED
<br />PROPERTY DAMAGE
<br />X HIRED AUTOS AUTOS
<br />Pie ;accident) r
<br />B
<br />x
<br />UMBRELLA LIAB X OCCUR
<br />1110112015
<br />11101/2016 EACH OCCURRENCE 3 5,000 000
<br />EXCESS LIAB CLAIMS -MADE
<br />AGGREGATE S 5.000.000
<br />DED , X RETENTION $ 25 „000
<br />__.._ $
<br />A
<br />WORKERS COMPENSATION
<br />WCUC48593537
<br />11401/2015
<br />11/01/2016
<br />X ��gr�1E ERH_
<br />AND EMPLOYERS' LIABILITY Y I N
<br />_
<br />1
<br />MANY PROP RIETORIPARTNERIEXECUTIVE
<br />CA - $1,000,000 SIR
<br />..00©,00©
<br />E.L. EACH ACCIDENT ;*p
<br />.- .........._ ._ .- .._m..— —.
<br />IManda ofry in NH) EXCLUDED? N
<br />N f A
<br />CH WA OR IL MI - $500K SIR
<br />r 1,0f5Q 000
<br />EI L. DISEASE - EA EMPLOYEE �
<br />OOQ 000
<br />Me ycs, describe under
<br />DESCRIPTION OF OPERATIONS astlow
<br />E.L. DISEASE - POLICY LIMIT $
<br />A
<br />Professional Liability
<br />623645233009
<br />I 7101/2015
<br />7/01/2016
<br />$5,fl00,000 Each claim
<br />$5,000,000 Aggregate
<br />'f
<br />$1 000,000 Retention
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 109, Addlllonal Remarks schedule, may be attached it more space is required)
<br />,lob #3733 Jobsite: Parks, Recreation & Community Services Agency City of Santa Ana 20 Civic Center Plaza, Santa Ana, CA.
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as additional insureds as respects general liability as
<br />required by written contract with the Named Insured. If required by the written contract or agreement with said additional insureds, this insurance shall be
<br />primary insurance to any other insurance available to said insured covering the same loss. Such other insurance available to said additional insureds shall
<br />be excess to and non - contributing to this insurance. Thirty (30) days written notice of cancellation or non- renowal shall be given to the additional insured(s)
<br />in the event of cancellation of the general liability, automobile liability, workers` compensation and umbrella pofcy(ies).
<br />(CERTIFICATE MULDER UANCUtLL.A 1 IlL N
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Attn: Silvia Cuevas ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza m-23
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />The ACORD name and logo are registered marks of ACORD O 1985 -2014 ACORD CORPORATION, All rights reserved.
<br />ACRD 25 (2014/01) 111111111111 1111111 1111111 X111111 11111 11111 11111 1 1111111111111111111111 11111111111111 &5A�66G�1,51�21�6,, rvl�'
<br />
|