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WESTCOM-16 SGONZALEZ
<br />ACORO CERTIFICATE OF LIABILITY INSURANCE
<br />DATE 04/26/2018Y)
<br />oat2st2o18
<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.
<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 # 0757776 NAMEACT Jordan Bartleson
<br />HUB International Insurance Services Inc. PHONE FAX
<br />3390 University Ave., Ste 300 (A/C, No, Ext): (951) 779-8575 (A/C, No).(951) 231-2572
<br />Riverside, CA 92501 E-MAIL cal.cpu@hubinternational.com
<br />A-2015-112-03 � -
<br />Ltd. 111000
<br />INSURED INSURER B : Hartford Accident and Indemnity Compan 122357
<br />Westbound Communications, Inc. I INSURER C :Axis Insurance Company 137273
<br />625 The City Drive, Suite 480
<br />Orange, CA 92868
<br />RER E:
<br />F:
<br />COVERAGES CERTIFICATE NUMBER: 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
<br />THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR ADDL SUBR POLICY EFF POLICY EXP
<br />ITP TYPE OF INSURANCE iucn wvn POLICY NUMBER LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />EACH OCCURRENCE $
<br />DAMAGE TO RENTED
<br />X 72SBAIB4627 05/06/2018 0510612019 PR�""ISEC,E�p;r,E,,Lcgj $
<br />2,000,000
<br />1,000,000
<br />MED EXP (Any one person) $
<br />PERSONAL & ADV INJURY
<br />10,000
<br />2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRO F LOC
<br />X POLICY ElJECT
<br />GENERAL AGGREGATE $
<br />PRODUCTS - COMP/OP AGG $
<br />4,000,000
<br />4,000,000
<br />OTHER:
<br />I $
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT $
<br />2,000,000
<br />BODILY INJURY Per person) $
<br />ANY AUTO 72SBAIB4627 0510612018
<br />0510612019
<br />OWNEDSCHEDULED
<br />AUTOS ONLY AUTOS
<br />I BODILY INJURY Per accident $
<br />PROPERTY DAMAGE
<br />(Per accident) $
<br />X
<br />HIRED X NUTN
<br />AUTOS ONLY AUTOS ONLY
<br />A
<br />X UMBRELLA LIAB X OCCUR2,000,000
<br />.EACH OCCURRENCE $
<br />EXCESS LIAB CLAIMS -MADE 72SBAIB4627 05/06/2018 0510612019 f AGGREGATE $ _
<br />2'000'000
<br />DED T X RETENTION $ 10,000
<br />B WORKERS COMPENSATION
<br />ANO EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER
<br />and R/MtoryEn NH) EXCLUDED) �i,
<br />N / A
<br />72WECLR3783 0912812017 0912812018
<br />X PER OTH-
<br />STA UTE FR — —
<br />E.L. EACH ACCIDENT $
<br />1,000,UUU
<br />E.L. DISEASE - EA EMPLOYEE $
<br />1,000,000
<br />H yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />C Pofessional Liab MCN000234351701 0912512017 0912512018 Per Claim
<br />3,000,000
<br />C Retention: $10,000 MCN000234351701 0912512017 0912512018 Aggregate
<br />3,000,000
<br />DESCRIPTION OF OPERATIONS / 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, volunteers and representatives are Additional Insured in regards to General Liability per form
<br />IH12001185 which includes 30 Day Notice of Cancellation. Primary & Non -Contributory wording and Waiver of Subrogation coverages apply to the General
<br />Liability policy when required by written contract per the attached endorsement SS0008 04105 (pgs. 16-17 of 24).
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Cit of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD a to o are registered marks of ACORD
<br />('�� IPI �� ��
<br />
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