R.T. CLOWN, INC. - 2016 - Laserfiche WebLink

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a� Qe CERTIFICATE OF LIABILITY INSURANCE D E(M9/2016") 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 have ADDITIONAL INSURED provisions or 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 confar rights to the certificate holder in lieu of such andomement(s), PRODUCER Edgewood Partners Insurance Center (EPIC) 19000 MacArthur Blvd. PH Floor Irvine, CA92612 CONTACT van Deng______ PHONE "I'L-ext _ _ — —�I FAx -- 9as.a1�.91i3 LAJCI,10)_.__9a9.z63.o9os_ 466REss:_____..__VVdangQedgewoodins.com INSURERIS) AFFORDING COVERAGE _ NN664986 8/14/2016 INSURER A: Nautilus Ins. Co. EACHOCCURRENCE www.odgewoodins.com INSURED R.T. Clown, Inc. 461 Altura Way INSURERS:------------- CLAIMS-MAUE OCCUR -- INSURERc, --- INSURERD: Manhattan Beach CA 90266-2369 INSURER E ---- $ 100,00_0 MED Exa (Any ono pmean INSURER F:_— --_— _✓ COVERAGES CERTIFICATE NUMBER:' 81325493 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. INSR LTR TYPE OF INSURANCE AD DL SWI POLICY NUMBER MO�IDINYYY MMIO�tYY _ LIMITS A ,/ COMMERCIAL GENERAL LIABILITY�/ _ NN664986 8/14/2016 8/14/2017 EACHOCCURRENCE $ 1,000,909 CLAIMS-MAUE OCCUR TJ7,EE(Co o T€ -D—_- -S Rn wu nure PREMISES ---- $ 100,00_0 MED Exa (Any ono pmean $ 5,000 _✓ BI/PD Deductible: $500 PERSONAL B ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PF.R: GENERAL AGGREGATE S 2,000,000 ✓ POLICY n JEGT LOC PRODUCTS AGG S _ _Included $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT$ BODILY INJURY (P., person) $ ANYAU10 OWNED AUSCHEDULED AUTOS ONLY TOS HIRED NOWOWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accidanp $ OPERTY DAMAGE PRPer accidenll _ $ $ r UMBRELLA LIA@ OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIA@__J J CLAIMS -MADE DED RETENTION$----- --' $ ---- WORKERS COMPENSATIONPE AND EMPLOYERS' LIABILITY YIN ' ANWROPRICTORIPARTNERICXEOUTIVE ❑ OFFICERIMEMREREXCLUDED? (Mend.toryinNil) NIA 2f DTH. STATUTE_._ FR __� EA-, EACH ACC1DENT $ E.LDISEASE-EA EMPLOYEE - -'— '- $ If yyes, daeoribe under Df:SCRIPTIONOPOPERATIONS hal. �' E.L. DISEASE, POLICY LIMIT --'-'--- $ t°e Y�'R` DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (AC OR0101, AddiBonul R.anuks S d n r�ayyl c�.0�u rmora upon. le roq.i.d) The City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ?Iii 93 1 16-1-1 01, 1/A: I Van bang 1 8/11/201e 4ay,34 PH IWO) I Page 3 of 2