R&S OVERHEAD DOORS OF SO-CAL, INC. - 2016

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R&SEREC-01 BSHAN ,4Co�zo" CERTIFICATE OF LIABILITY INSURANCE L...-� DTUM//22016 1A2/146 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 License At OC36861 New York-Alllant Ins Svc Inc 320 West 57th St New York, NY 10019 CONTACT Eileen Kivlighn TNAME PHONE FAX AIC No Ext: AIC No: E -MAIL Elloon.kivilghn@alliant.com -ADDRESS, INSURERS) AFFORDING COVERAGE NAIL# INSURERA:WOSCOInsurance Company 25011 INSURED R & S Overhead Door of Southern California, Inc. 1617 N. Orange Thorpe Way Anaheim, CA 92801 INSURER B: California Capital Insurance Company 13544 INSURER C: Starr Indemnity & Liability Company 38318 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. CTR TYPE OF INSURANCE INSD WVD POUCVNUMBER MMID�IVYYV POLICY EXP LIMITS A X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR X WPP120995402 11/01/2016 11/0112017 D MAGERENTED- TORENTE 100,000 PREMISES Ee nce $ MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY L JECOT 1:1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 _ $ OTHER'. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ B X ANY AUTO 3 -BAA -1-049656 11/01/2016 11/01/20171 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Par accident $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE AGGREGATE C X EXCESS une CUIMS-MADE 1000023175 11101/2016 11/01/2017 DEO X RETENTION$ 10,000 q WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXIE TIVE OFFICERIMEMBER EXCLUDED4(Mandatory NIAE.L. PER OTH- STATUTE ER EACH ACCIDENT in NH) E. L. DISEASE -EA EMPLOYEE EL.DISEASE - POLICY LIMIT $ If yes, descnbe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insured on a primary and non-contributory basis as required by written contract. REVISED /� (Z'/ 1 � /7 CERTIFICATE HOLDER CANCELLATION M1M%.xFIL11V1A %0MLAr mo ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Santa Ana Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza, M-11 Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD