Laserfiche WebLink
ACO/ZO® CERTIFICATE OF LIABILITY INSURANCE <br />0DATE 3/14 /201YYV) <br />03/14/2016 <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 1 -866- 220 -4625 <br />Holmes Murphy and Associates - Omaha <br />CONTACT <br />NAME: <br />PHONE FAX <br />IAIC, No Extl AIC No <br />E -MAIL <br />ADDRESS: <br />2637 South 158th Plaza <br />Suite 200 <br />Ana, CA 92702 <br />Omaha, NS 68130 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURERA: TRAVELERS PROP CAS INS CO <br />36161 <br />INSURED <br />Pen -Link, Inc. <br />INSURERS: TRAVELERS IND CO <br />25658 <br />INSURERC: TRAVELERS PROP CAB CO OF AMER <br />25674 <br />INSURER D: <br />PREMISES Ea occurrence <br />PREMIETOaoccan <br />5936 Vanlervoort Drive <br />INSURER E: <br />$10,000 <br />Lincoln, HE 68516 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 46302041 REVISION NUMBER: <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 />INBR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MMIODIYYYY <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />Santa <br />Ana, CA 92702 <br />ZLP91M48306 <br />12/18/1 <br />12/18/16 <br />EACHOCCURRENE <br />$1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />PREMISES Ea occurrence <br />PREMIETOaoccan <br />$ 300,000 <br />MED EXP(Any one person) <br />$10,000 <br />CLAIMS -MADE OCCUR <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMPIOP AGG <br />$2,000,000 <br />X POLICY X PRO- PRO- <br />$ <br />B <br />AUTOMOBILE <br />LIABILITY <br />BA5G901158 <br />12/18/1 <br />12/18/16 <br />COMBINED SINGLE LIMIT <br />Ea addidurrh <br />$ 1,000,000 <br />BODILY INJURY (Par parson) <br />$ <br />ANY AUTO <br />ALL OWNED F7 SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per <br />(a 1 <br />$ <br />X <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />C <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />ZPP41M46674 <br />12/18/1 <br />12/18/16 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />AGGREGATE <br />$ 5,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ 10, 000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />UB5G909469 <br />12/18/1 <br />12/18/16 <br />WC S L IT - DTH- <br />X TATU <br />E, L. EACH ACCIDENT <br />$ 500,000 <br />E. L. DISEASE - EA EMPLOYEE <br />$ 500,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E,L. DISEASE- POLICY LIMIT <br />$ 500,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACO RD 101, Additional Remarks Schedule, if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2010105) <br />kworkmanne <br />46302041 <br />©1988.2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Santa <br />Ana Police Department M -97 <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ATTN: <br />Garrison Fradella <br />60 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa <br />Ana, CA 92702 <br />_� <br />USA <br />ACORD 25 (2010105) <br />kworkmanne <br />46302041 <br />©1988.2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />