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INSURE PROTECTIVE SECURITY 3 - 2015
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INSURE PROTECTIVE SECURITY 3 - 2015
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Last modified
5/26/2017 2:21:08 PM
Creation date
9/14/2015 12:54:00 PM
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Contracts
Company Name
INSURE PROTECTIVE SECURITY
Contract #
N-2015-144
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
9/30/2015
Insurance Exp Date
9/22/2016
Destruction Year
2020
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Policy Number: <br />Date Entered: 9/25/2014 <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE9/20IY5 <br />�./ <br />8/19/2015 <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 <br />ASL Insurance Services <br />CONTACT <br />_NAME: __. ... <br />PERSONAL &ACV INJURY <br />PHONE (818) 957-3366 arc No: (818) 957-3369 <br />AIC <br />3533 North Verdugo Road <br />E-MAILAA ILADDREs: instogo4@sbcglobal.net <br />Glendale, CA 91208 <br />OTHER: i <br />INSURER(S) AFFORDINGCOVERAGE NAIC# <br />INSURER A:sCOttsdale Insurance Company <br />$ <br />INSURED <br />INSURER B;State Compensation Insurance Fund <br />Insure Protective Security, Inc. <br />INSURERC_:_ <br />_,. <br />INSURER D:._ <br />6200 Stoneridge Mall Road Suite 300 <br />INSURER E. <br />Pleasanton, CA 94588 <br />_ <br />INSURER F:— —�-- <br />$ <br />nnvvv A/_Cc m=13TICIPATC NIIllifiC. RFVIRION NIIMRFR2 <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 <br />TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />Y EXP <br />INSR TYPE OF INSURANCE �ADDL SUBR POLICY NUMBER MM _PO01� VYVV MMID� YVVY LIMITS <br />LTR <br />A X COMMERCIAL GENERAL LIABILITY'S EACH OCCURRENCE <br />$1,000,400 <br />CLAIMS -MADE . OCCUR IX 'CPS1992289 9/23/2014 9/23/2015 DAMAGE TORENTED <br />curmncel <br />_ <br />ERRORS & OMISSIONS MED EXP(Anyaneperson) <br />'$5,000 _ <br />PERSONAL &ACV INJURY <br />$1,000,000 <br />CENT,AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE <br />'� �•' PRODUCTS COMPIOP AGG <br />XPOLICY PRO-JECT '.. <br />$3,000,_000 <br />$3,000,000 <br />LOC p� - <br />— <br />``���V <br />OTHER: i <br />$.. <br />AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT <br />(Ea accident ___ <br />$ <br />ANV AUTO ,,11gCJ BODILY INJURY For person) <br />$ <br />ALL OWNEp SCHEDULED Pj`rV BODILY INJURY (Per accide-n-t) <br />AUTOS <br />$ <br />NON -OWNED PROPERTY DAMAGE <br />H REOSAUTOS AUTOS Sell <br />$ <br />$ <br />UMBRELLA LIAB OCCUR EACH OCCURRENCE <br />—� <br />$ <br />EXCESS LIAR CLAIMS MADE - AGGREGATE <br />IS <br />DED RETENTION$ <br />$ <br />WORKERS COMPENSATION PER Ulm - <br />STATUTE _ER___ <br />AND EMPLOYERS' LIABILITY_ <br />V / N <br />$1,000,000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE [7 N/A 9100826-15 5/28/2015 5/28/2016 E.L. EACH ACCIDENT <br />B -- <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE. <br />$ 1, 000, 000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT <br />$ 1 , 000, 000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Batteries Schedule, may be attached if more space Is required) <br />The City of Santa Ana, it's officers, employees, agents, and representative are included as <br />additional insured on the General Liability policy with respects to the operation of the named <br />insured only. <br />* Except 10 day notice of cancellation for non-payment of premium. <br />City of Santa Ana, Its officers, <br />Employees, Agents, Volunteers and Representatives <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />TAIME LUGO <br />ACORD CORPORATION. All rights <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />Produced using Forms Bass Plus software, www FormsBoss.com, Impressive Publishing 800-2081977 <br />
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