ACCURATE PERFORMANCE MACHINING, INC. - 2016

Home Browse Search

A� p® CERTIFICATE OF LIABILITY INSURANCE DATY E/24/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Executive Team Insurance Services, LLC An Affiliate of United Agencies, Inc. 23421 S. Pointe Drive Ste,190 Laguna HMIs, CA 9265'3 CNAME:ONTACT Executive Team Insurance Services LLC PRDNE Fax AIC No Ext 626-214-7902 AIC No: E-MAIL ADOREss: etisunited uniteda encies.com INSURERS AFFORDING COVERAGE NAIC N ✓ INSURERA: Nova Casualty Company M50CLOO10119-4 OG23764 INSURED Accurate Performance Machining Inc. 2086 S. Grand Avenue INSURER B: INSURER C: INSURERS: Santa Ana CA 92705 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 787ommn REVISION NUMBER' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSO Won BR POLICY NUMBER POLICY EFF MM/DDNYYPY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MAGE OCCUR' ✓ M50CLOO10119-4 6/15/2015 6/15/2016 EACH OCCURRENCE $ 1,606,600 PREMSES(Ea oceteence) $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GENL ✓ POLICY JECCT LOC PRODUCTS-COMP/OPAGG $ Excluded $ OTHER' AUTOMOBILE LIABILITY COMBINED S INGLE LIMIT $ Ee e..Iddnt BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Pereccideni $ i NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Per.add o $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UALCLAIMS-MADE DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUOED9 F-1 NIA ATWO0703200 6/15/2015 6/15/2016 STATUE ERH EACH ACCIDENT $ 1,000,000 E. L. DISEASEEA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E, L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schetluie, may be attachetl lfmore speae is requiredI p t� The City of Santa Ana, its officers, employees, agents, and representatives are named as additional insureds in respects to the general liability policy only per the attached forms.8.- CERTIFICATE HOLDER CANCELLATION Celt of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana Work Center THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Gary Champlin © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 20900850 1 15-16 GT. & WC I Katherine Oumatol 12/24/2016 1:37:39 PM (PST) I Page 1 of 6 Exhibit C