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MVRCONS-02 GFIETSCH
<br />"
<br />DATEYYYY)
<br />.ft CERTIFICATE OF LIABILITY INSURANCE
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />�
<br />3/12/201212017
<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(les) 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 endorsement(s).
<br />PRODUCER License # 26480
<br />CO TCT
<br />HUB International Mountain States Limited
<br />PHONE
<br />(AIC, Ne, Ex1): (208) 433-1000 Arc, No :(866) 898-4905
<br />2600 Rose Hill, Suite 101
<br />E-MAIL
<br />AD4REss
<br />PO Box 5815
<br />Boise, ID 83705
<br />10,000
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURER A; Sentinel Insurance Company, Ltd. _ _ 111000
<br />INSURED
<br />INSURER B:
<br />MVR Consulting
<br />INSURER C: _
<br />P.O. Box 236
<br />IN ER D:
<br />Callmesa, CA 92320
<br />I
<br />I
<br />INSURER E ;
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMHER:
<br />THIS IS TO CERTIFY THAT THE POLIC€ES 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 />1NSR ADDL SUER'. POLICY EFF 9 POLICY EXP '',
<br />TYPE OF INSURANCE 1NSp I WVD POLICY NUMBER p LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />EACH OCCURRENCE 2,000,000
<br />CLAIMS -MADE X OCCUR
<br />X
<br />348BMIJ6649 021221'2017
<br />02/2212018 ' DAMAGE TO RENTED 1,ODD,OOD
<br />X131 MIB.iEa.szucurrslcP)---� —.. 00
<br />X li Hired Auto &
<br />10,000
<br />_MED EXP (Any one person) -_
<br />X
<br />Non -Owned Auto
<br />I
<br />I
<br />2,000,000
<br />PERSONAL &ADV INJURY $
<br />GEN'LAGGREGATELIMITAPPLIESPER;
<br />- - —
<br />i
<br />GENERALAGOREGATE - $ 4,DOD,ODO
<br />X
<br />POLICY PZO- LOC
<br />J CT
<br />j
<br />._... .. .
<br />4,DOD,DDD
<br />PRODUCTS-.COMPIOPAGG__. S-,_____--____
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />I
<br />I !
<br />i
<br />COMBINED SINGLE LIMIT
<br />ANY AUTO
<br />j
<br />BODILYINJURY(PeUersan) : $_---._.,,., ........._.
<br />OWNED ;� SCHEDULED
<br />—...-
<br />AUTOS ONLY _: AUTOS
<br />BODILY INJURY {Per accident , $ ._.. ._-.
<br />HIRED N�N-O NED
<br />If
<br />AUTOS ONLY A TOS ONLY
<br />-�Pe�acEcideAMAGE-- $
<br />_
<br />I $
<br />UMBRELLA (-IAB
<br />—i OCCUR
<br />EACH OCCURRENCE S
<br />H
<br />EXCESS LIAe
<br />CLAIMS -MADE]
<br />, ---
<br />AGGREGATE
<br />DED RETENTEON$
<br />WORKERS COMPENSATIONI
<br />AND EMPLOYERS' LIABILITY
<br />i
<br />PER : OTH-
<br />STAR TE.____I-EF2_......'',...
<br />YIN
<br />ANY PROPRIETORfPARTNERIEXECUTIVE
<br />E.L.NlA EACH ACCIDENT-_
<br />oMyFMNEXCLUDED?
<br />O1(�MFaFnICdEatWrn
<br />E.L. DISEASE - EA EMPLOYEE -
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below'
<br />E,L. DISEASE - POLICY LIMIT', S
<br />DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />The City of Santa Ana, It's officers, employees, agents and representative are Additional Insureds with respects to General Liability when required by written
<br />contract per form SS0008,
<br />fVtEWCk BY: I UNiCE HE EPI (PG OF ) . .
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2016103) O 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City
<br />Cit of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Finance & Management Services Agency
<br />20 Civic Center Plaza M-16
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />ACORD 25 (2016103) O 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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