SUSY PARTY RENTAL 4 - 2017 - Laserfiche WebLink

Home Browse Search

A`6 o® CERTIFICATE OF LIABILITY INSURANCE onrE(mmlDDrcyrY 06/30/2017 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(ies) 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 Mclure Insurance Brokerage, Inc. NAMEACT Ray Mclure PHONE 714 664-8911 FAX N.1- nooalEss: ray@mclureins.com 17671 Irvine Blvd. #101 INSURERS AFFORDING COVERAGE NAIC0 INSURER A: COLONY INSURANCE COMPANY 39993 Tustin CA 92780 INSURED INSURERS: STATE FUND INSURANCE COMPANY INSURER G: Susy Party Rentals INSURER D: 1517 S Sycamore St INSURER E: INSURER F: Santa Ana CA 92707 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 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. ILTR TYPE OF INSURANCE ADDLS D BR O POLICYNUMBER POLICYEFF MMIDD POLICY EXP MMI00 OMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea a.mmea S 100,000 MED EXP An one person) S 5,000 - I PERSONAL& ADV INJURY S 1,000,000 A Y IOIKGO044107-01 01/16/2017 01116/2018 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY D jECT [7 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ea accident BODILY INJURY (Per person) S ANYAUTO BODILY INJURY(PeraWdent) S ALL OWNED SCHEDULED AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE S Peraccldent UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS LIAR CLAIMS -MADE OEO I I RETENTIONS S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY �ICERIME BEREXC UDEDT ECUTIVE Y❑ (Mandatory In NH) NIA Y W/O TBI 06/29/2017 06/29/2016 I PER ER E.L EACH ACCIDENT $ 1.000,000 E.1- DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE -POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additlonal Remarks Schedule. may be attached If more space is requlrred).6 CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ?0\0VV �I �eJas SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 All riahts reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD