INTERIOR DEMOLITION, INC.-2017 - Laserfiche WebLink

Home Browse Search

CERTIFICATE OF LIABILITY INSURANCE 2I412��onYvv) THIS CERTIFICATE 19 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(ies) most 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 endorsern®nt s . PRODUCER HUB Int'I - CAL Bronson 3636 American River Drive Suite 200 CONTACT NAME .......... - PHONE 916 480 49 96 Ax 916------- 96 (�rc,.nE� ExL)._.____._.--..:..................._..----------__._...tevc N>.___.---.-----------.--..__.-....... EMAIL Kasey.Dough ert hubintemational.com _t�DnReS�:_._._..-----..__ Sacramento CA 95864 .................-.Y@---------------- -- ............... -- INSURERS AFFORDING COVERAGE MAIC 9 INSURERA:State Compensation Ins Fund of CA 35076 INSURED INTEDEM-01 INSURER 8: Interior Demolition Inc 2621 Honolulu Ave. INSURER C: Montrose CA 91020 INSURER D ; INSURER E: INSURER F DAMAGE TO RENTED PREMISES Ea occurrence COVERAGES CERTIFICATE NLIMRF-R- 1667442175 RFVIgIr)N NI MAK PP: 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 INSR WVD POLICY NUMBER I POLICY EFF MMIDDlYYYY POLICY EXP MMlDD YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRFNCE $ CLAIM S -MADE I— OCCUR DAMAGE TO RENTED PREMISES Ea occurrence MED EXP (Any one person) $i PERSONAL & ADV I NJURY $ GEN'LAGGRFGATE UMITAPPLIES PER: GENERAL AGGREGATE $ pPOLCY ❑ PRO- LOC JECT _.Y.--- ----- PRODUCTS - COMPfOP AGG $ OTHER AUTOMOBILE LIABILITY i U IN IF_ LIMIT $ (Ea accident) _ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS E BODILY INJURY (Per accident) $ - i NON -OWNED—....--- I -TIRED AUTOS PROPERTY DAMAGE - $ AUTOS (Par accident) $ i UMl3RELLALIA6 OCCUR EACH OCCURRENCE $ € EXCESS LIABCLAIMS-MADE AGGRf_GATE $ .,.._..._._ _._....,--- DD ERETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y 1977624-2016 ; 917.712016 9/27/2017 X PER I OTW- TE L____ STATU_ Y I N ANY PROPRIE'1'OTPAR7NERIEXECUTIVE _ -I_ER E.L. EACW ACCIDENT $1,000,000 i OFFICERINIEMI3ER EXCLUDED? Y N ! A _ _ ......._._.-----------------....__........., Mandato In NW ---' (Mandatory ) I E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under -------- —------------ .....,._...........---------------.................. i DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 i i i I I i i DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 901, Additional Remarks Schedule, may be attached If more space is required) RE: Work performed by the named insured under written contract by the certificate holder. Additional Insured: City of Santa Ana where required by written contract. Forms: 10217 0112 era i iravr3 e � r�r.,i r..r-r r:: r't City of Santa Ana 20 Civic Center Plaza - Ross Annex (M) 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. AUTHORIZED REPRESENTATIVE C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and longe are registered marks of ACORD