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Last modified
2/13/2018 4:58:56 PM
Creation date
8/9/2017 2:50:38 PM
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Contracts
Company Name
IBI GROUP
Contract #
A-2015-247-02
Agency
Public Works
Expiration Date
12/31/2017
Insurance Exp Date
4/30/2018
Destruction Year
0
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ACOR-1 W <br />CERTIFICATE OF LIABILITY INSURANCEF77701/09/2018 <br />MM/DD/YYYY) <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 have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Aon Risk services Central, Inc. <br />Minneapolis MN Office <br />CONTACT <br />NAME: <br />PHONE (952) 886-8000 FAX (312) 381-0536 <br />(A/C. No. Ext): (A1C. No.): <br />5600 West 83rd Street <br />8200 Tower, Suite 1100 <br />E-MAIL <br />ADDRESS: <br />Minneapolis MN 55437 USA <br />EACH OCCURRENCE <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURED <br />INSURER A: Twin City Fire Insurance Company 29459 <br />IBI Grouo US <br />18401 Von Karman Ave. Suite 110 <br />INSURER B: <br />INSURER C: <br />Irvine CA 92612 USA <br />INSURER D: <br />AUTOMOBILE LIABILITY <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLYAUTOS <br />HIREDAUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />INSURER E: <br />INSURER F: <br />L;UVtKAUtb l;tKllhl(;Alt NUMULK: 01UUbyyUlJlJ1 REVISION NUMBER: <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. Limits shown are as requested <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADD <br />INSO <br />SUBR <br />WVD <br />POLICY NUMBER <br />LI EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MMIDD/YY <br />LIMITS <br />AUTHORIZED REPRESENTATIVE <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ❑OCCUR <br />PO BOX 1988 <br />Santa Ana CA 92702 USA <br />EACH OCCURRENCE <br />DAMAGE TO N D <br />PREMISES Ea occurrence <br />MED EXP (Any one person) <br />PERSONAL& ADV INJURY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ 1111-F—]LOCJECT <br />OTHER: <br />GENERAL AGGREGATE <br />PRODUCTS - COMP/OPAGG <br />AUTOMOBILE LIABILITY <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLYAUTOS <br />HIREDAUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />COMBINED SINGLE LIMIT <br />(Ea, <br />a accident <br />BODILY INJURY ( Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per accident) <br />UMBRELLALIAB <br />EXCESS LIAB <br />HOCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />AGGREGATE <br />DED RETENTION <br />A <br />WORKERS EMPLOYER COMPENSATIONLIABILITY AND YIN <br />ANYPROPRIETOR/PARTNER/EXECUTIVE M <br />OFFIOER/MEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N I A <br />41WEID5484 <br />01/13/2018 <br />01/13/2019 <br />X STA UTE OTH- <br />E.L. EACH ACCIDENT $1,000,000 <br />E.L. DISEASE -EA EMPLOYEE $1,000,000 <br />E.L. DISEASE -POLICY LIMIT $1,000,00 <br />REVIEWED BY: EUNICE HEREDIA (PG �Pr ) <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Reference: SARTC Parking Plan. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />r-� <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />City of Santa Ana <br />20 Civic center Plaza <br />AUTHORIZED REPRESENTATIVE <br />PO BOX 1988 <br />Santa Ana CA 92702 USA <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />r-� <br />
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