Laserfiche WebLink
CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DDNYYY) <br />THIS ww CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS a <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsemenfml <br />PRODUCER <br />Ashbrook-Clevidence, Inc. <br />3000 W MacArthur Blvd, Suite 320 <br />Santa Ana, CA 92704 <br />License#:0188788 <br />NAMEYCT <br />Mitch Clevidence <br />PHONE (714)979-4023 FAX ,. <br />(71a 9Ts 2ecs <br />noo ILss: much clevidencexom <br />INSURE SAFFORDINGCOVERAGE <br />NAICa <br />INSURER A: <br />INSURER 8: <br />INSURER C: <br />Continental Casualty C m <br />Scottsdalg Insurance C <br />an <br />an <br />20443 <br />INsuREO <br />Data Ticket, Inc. <br />DBA Revenue Experts <br />2603 Main Street Suite 300 <br />Irvine, CA 92614 <br />COVERAGES CERTIFICATE NUMBER: <br />00000000-0 <br />412 7 <br />INSURER D: <br />NsuRER E: <br />INSURER F: <br />REVISION NUMBER: 12 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED <br />NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM CONDITION OF ANY CONTRACT OR OTHER DOCUMENT <br />WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT <br />TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />TYPE OF INSURANCE ADDL.SUB POLICY EFF MMM EXP LIMITS <br />POLICY NUMBER M <br />MERCIAL GENERAL LIABILITY <br />CIAIMS.MADE ❑ OCCUR <br />EACH OCCURRENCE <br />$ <br />PREMISES Ea occurrence) <br />$ <br />— - -$VDeduCt$26K$IMM12MM <br />SONAL S ADV INJURYGREGATE <br />UMITAPPUESPER: <br />❑ JECT LOCDUCTS-COMPIOPAGG <br />ERAL AGGREGATE <br />$ICY <br />SER: <br />L J <br />LCP- <br />E - <br />ILELIABILITY <br />BBIINdEED N LELIMIT <br />$ <br />AUTOILY <br />INJURY(Per person) <br />$SOME <br />SCHEDULED__S <br />$D <br />ONLY AUTOS <br />NON-ONNEDPERTY <br />ILY INJURY(Per accident) <br />DAMAGE <br />�aERELLA <br />$ <br />S ONLY AUTOSONLY <br />LWB <br />OCCUR <br />OCCURRENCE <br />$SS <br />LIAR <br />REGATE <br />ERErENfIONE <br />COMPENSATION <br />PER OTH.AND <br />$WORIORS <br />EMPLOYERS' LIABILITY YIN <br />STAT ERANY <br />PROPRIETORIPARTNERIFJ(ECUTPEOFFICEMMEMBER EXCLUDEDi <br />N / A <br />ACH ACCIDENT <br />$(MandatoryinNH)If <br />ISEASE. EA EMPLOYE <br />$ <br />yes,dascrbeunder <br />OF OPERATIONS bslavISEASE-POLICY <br />LIMIT <br />_DESCRIPTION <br />$A <br />Errors 8 Omm <br />287188360 11/0112018 11/01. <br />$10K <br />$2,000,000B <br />CyberLiability <br />EKS3272472 11/01/201811/01uct$26K <br />$1MMI2MM <br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACOM101,Additional RemaMs Scbedule, may c aMMcbed lfmora space is required) <br />Certificate evidences Professional Liability (Errors & Omissions)& Includes Personal Injury, Cyber Liability and Crime (provided <br />by Travelers Casualty & Surety Company of America NAIC #31194) <br />r FormIrnI..11 r1Cr, nrvr taut.- o ..l. .'. .- <br />City of Santa Ana <br />Risk Management Div <br />20 Civic Center Plaza, <br />Santa Ana, CA 92702 <br />MANAgEMENT E <br />2019 <br />JTH M. LAM <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />v <br />reserved. <br />r- •----I r Ue saa.vnu name ana Togo are registered marks of ACORD <br />Printed by MXC on August 16, 2019 at 01:54PM <br />