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ACORCI® CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />16/14/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />HUB Int'I - CAL Bronson - License #0757776 <br />3636 American River Drive, Suite 200 <br />Sacramento CA 95864 <br />CONTNAME: Cheri Greco <br />PHONE 916-480-4153 F4't 916-993-7253 <br />.Jxt) (A/c " <br />E-MAIL I Greco <br />�D�RESS; Cher hubinternational.com y • @ <br />INSURERS AFFORDING COVERAGE <br />NAIC 9 <br />Y <br />INSURERA:AI'Ch Specialty Insurance Company <br />21199 <br />6/4/2017 <br />INSURED INTEDEM-01 <br />INSURER B :.Redwood Fire and Casualty Ins Cc <br />_ <br />11673 <br />Interior Demolition Inc <br />INSURERC:State Compensation Ins Fund of CA <br />35076 <br />2621 Honolulu Ave. <br />Montrose CA 91020 <br />INSURER D : <br />X <br />------------------------------- <br />INSURER E <br />Contractors Poll <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 1147577471 REVISION NUMRER- <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD� <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />12 EMP 71972 06 <br />6/4/2017 <br />6/4/2018 <br />EACH OCCURRENCE $1,000,000 <br />CLAIMS -MADE X1 OCCUR <br />DAM AGESt RENTED <br />PREMISES Ea occurrence $50,000 <br />X <br />MED EXP (Any one person) $5,000 <br />Contractors Poll <br />X <br />Profess. Liab <br />PERSONAL&ADV INJURY $1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $2,000,000 <br />i POLICY � PE� E LOC <br />PRODUCTS - COMP/OP AGG $2,000,0.0_0 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />X <br />LIABILITY <br />A1NY AUTO <br />01 APM 004498-04 <br />6/4/2017 <br />6/4/2018 <br />(O BIKED GEL T $1,000,000 <br />-- ----------------- <br />BODILY INJURY (Per person) $ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) $ <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />A <br />UMBRELLA LIAB X <br />OCCUR <br />112 EMX 71973 06 <br />6/4/2017 <br />6/4/2018 <br />EACH OCCURRENCE $5,000,000 <br />AGGREGATE $5,000,000 <br />X <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />y <br />1977624-2016 <br />9/27/2016 <br />( 9/27/2017 <br />X SPER <br />TATUTE ETH <br />EACH ACCIDENT $1,000,000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. <br />OFFICER/MEMBER EXCLUDED? ❑Y <br />N / A <br />E.L. DISEASE - EA EMPLOYE $1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT 1 $1,000,000 <br />I <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: Work performed by the named insured under written contract by the certificate holder. <br />Additional Insured: City of Santa Ana where required by written contract. <br />Forms: 10217 0112, EMP010100 0114, EMP006200 0504 <br />REVIEWED BY: EUNI('I- HER DIA (PG OF ) ll <br />CERTIFICATE HOLDER CANCELLATION <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza - Ross Annex (M) <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />irat_" <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE <br />