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KILEY COMPANY -2016
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KILEY COMPANY -2016
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Last modified
5/29/2018 4:37:46 PM
Creation date
11/8/2016 3:35:16 PM
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Contracts
Company Name
KILEY COMPANY
Contract #
A-2016-285
Agency
PUBLIC WORKS
Council Approval Date
10/4/2016
Expiration Date
10/5/2019
Insurance Exp Date
6/1/2018
Destruction Year
0
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CERTIFICATE OF LIABILITY INSURANCE <br />I m <br />TE <br />7 <br />4/14/20Y17 <br />004/14/20 <br />PRODUCE <br />STAT NSURANCE - JOHN LUITHLY <br />1627 CANYON RD STE F <br />IRVINE, CA 92618-4011 <br />THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE NAIL # <br />INSURED <br />ELIZABETH M KILEY INC <br />DBA KILEY COMPANY <br />2151 MICHELSON DR STE 205 <br />IRVINE, CA 92612 <br />INSURERA:State Farm General Insurance Company 25151 25151 <br />INSURERB:State Farm Mutual Auto Insurance Company 25178 <br />INSURERC:State Farm Fire and Casualty Company 25143 <br />INSURER D: <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />1NSR <br />ADD'L <br />ITS OFFICERS, EMPLOYEES & AGENTS <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />AUTHORIZED REPRESENT IVE <br />LTR <br />INSRD <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE MMIDOIYY <br />DATE MMMD/YY <br />LIMITS <br />A <br />X <br />GENERAL LIABILITY <br />92 -C9 -V665-7 <br />06/01/16 <br />06/01/17 <br />EACH OCCURRENCE $ 2,000,000 <br />COMMERCIAL GENERAL LIABILITY <br />AMA REN"fE <br />P REmsEs 2,000,000 <br />aone uror <br />CLAIMS MADE OCCUR <br />MED EXP (Any oon)� $ 5,000 <br />PERSONAL &ADV INJURY $ 2,000,000 <br />GENERAL AGGREGATE $ 4,000,000 <br />GENLAGGREGATE IMRAPPLIESPER <br />PRODUCTS - COMP/OP AGG $ <br />PRO - <br />POLICY J£CT LOC <br />B <br />X <br />AUTOMOBILE <br />LIABILITY <br />085 9537-BO1-75J <br />02/01/17 <br />08/01/17 <br />COMBINED SINGLE LIMIT <br />(Ea accident) $ <br />ANY AUTO <br />2014 MERCEDES <br />- <br />BODILY INJURY $ 1,000,000 <br />(Per person) <br />X <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />WDDLJ7DB5EA100763 <br />BODILY INJURY $ 1,000,000 <br />(Per accident) <br />X <br />X <br />HIREO AUTOS <br />NON-OVJN£DAUTOS <br />_ <br />PROPERTY <br />YtDAMAGE $ 1,000,000 <br />X <br />X <br />COMP DED - $500 <br />COLL DED - $500 <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: <br />AGG $ <br />A <br />X <br />EXCESSIUMBRELLALIABILITY <br />75 -CD -2498-7 <br />08/02/16 <br />08/02/17 <br />EACH OCCURRENCE $ 5,000,000 <br />OCCUR 1:D CLAIMS MADE <br />AGGREGATE $ <br />_. <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROP RIETOMPARTNER)EXECUTIVE <br />92 -CX -L783-0 <br />09/01/16 <br />09/01/17 <br />X WCSTATU- OTH- <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT $ 1,000,000 <br />E.L.DISEASE •EAEMPLOYEE $ 1,000,000 <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />CERTIFICATE AND ADDITIONAL INSURED COVERS AGREEMENT #A-2015-155, A-2011-068 AND A-2016-285 <br />.._._....._-_..... ... ,_.__ _._......_.._._..____.. <br />( RE VIE'��dED BY: _ ._ ..__.__ __.EUNIC:^E HEREDIA (PG C7I-_� _. <br />__....__._,__......,..__._.._.__.._�_....... _ .............__.._..__..._..._._.._.__w_._.._ ------- -._.____._._.�__-----...__� <br />CFRTIFICATE HOLDER CANCELLATION <br />ADDITIONAL INSURED: <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />CITY OF SANTA ANA <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />ITS OFFICERS, EMPLOYEES & AGENTS <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />C/O ROSS ANNEX <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENT IVE <br />20 CIVIC CENTER PLZ <br />SANTA ANA, CA 92701 <br />JOHN LUITHLY <br />ACORD 25 (2001108) 1 ne registration notices Inalcate ownership or the marKs by their respechv owners vHwrcv ��.Hcrvrtn t tvtr tZ500, cvvr <br />132849 03-13-2007 C/ All rights reserved <br />
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