|
''�� br CERTIFICATE OF LIABILITY INSURANCE
<br />DATE
<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 1–B32-476-6000
<br />Aon Risk Services Southwest, Inc.
<br />5555 San 6elipe, Suite 1500
<br />CONTACT
<br />N A : -
<br />PHONE - AX
<br />C o:
<br />ADDRESS:
<br />AFFORDING COVERAGE HAIGIf
<br />Houston, TX 77056-3089INSURERS
<br />INSURERA; INS CO 22322
<br />INSURED
<br />Clear Channel Outdoor, Inc.
<br />_GREENWICH
<br />INSURERS; XL INS AMERICA INC / XL SPECIALTY INS C
<br />– —
<br />INSURER C:
<br />COMMERCIAL GENERAL LIABILITY
<br />INSURER D:
<br />c/o 200 East Hasse Rd.
<br />INSURER E:
<br />11/01/16
<br />San Antonio, TX 78209
<br />1INSURER F:
<br />COVERAGES CERTIFICATE NUMBER- 51140258 oevrcrnar suusoem.
<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 />LTR
<br />TYPE OF INSURANCE
<br />AOOLS
<br />R
<br />POLICY NUMBER
<br />MOLICY EFF MIDDJYYYYI
<br />MMLUOY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />RGD300052802
<br />11/01/16
<br />11/01/17
<br />EACH OCCURRENCE $ 5,000,000
<br />CLAIMS -MADE rx-1 OCCUR
<br />PREMISES Ea odc nenoe $ 1,000,000
<br />MED EXP Any one person) $ Excluded
<br />PERSONAL &ADV INJURY $ 5,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $ 5,000,000
<br />GEN'L
<br />PRODUCTS - COMP/OP AGO $ 5,000,000
<br />POLICY JEC LOC
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />RAD943770902
<br />11/01/16
<br />11/01/17
<br />COMBINED SINGLE MIT
<br />E....ident$ 2,000,000
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Per person) $
<br />OWNED SCHEDULED
<br />BODILY INJURY (Per accident) $
<br />AUTOS ONLY AUTOS
<br />X
<br />HIREDX NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident $
<br />$
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE $
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE $
<br />DEO RETENTION$
<br />$
<br />E
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />RND300052902/RWR3002
<br />11/01/16
<br />11/01/17
<br />X STATUTE ORH
<br />YIN
<br />ANYPROPRIETOR/PARTNEWEXECUTIVE
<br />OFFICEWMEMBEREXCLUDE09
<br />NIA
<br />E.L. EACH ACCIDENT 1,000,000
<br />$
<br />_ _
<br />E.L. DISEASE- EA EMPLOYEE $ 1,000,000
<br />(Mandatory in NH,
<br />If yes, describe under
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />REVJEWED BY; A7Z
<br />EUNlGE HEREDiq (PG I OF�
<br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORO 101, Additional Remarks Schedule, maybe attechad if more space is required)
<br />RE: LEASE q 38847 AT 1221 E 3RD ST, SANTA ANA, CA 92701; LAX. 999058, LAX9990051, LAX9990055, LAX9990056
<br />Certificate Holder, its officers, employees, agents, volunteers and representatives as additional insured(s) on the
<br />liability policies, and such insurance is primary and non-contributory, but only to the extent of the liability assumed
<br />by the Named Insured under written contract.
<br />Workers Compensation is evidenced for employees of the Named Insured Only.
<br />30 days notice of cancellation as agreed by written contract.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />OF SANTA ANA, M-93 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />0 CIVIC CENTER PLAZA AUTHORIZED REPRESENTATIVE
<br />ANA, CA 92701 (/I� in .. [j���� �� ���� �yy
<br />USA LI4a 1VAR,(XM"tW�Olrl/uul.Al, 4,w-
<br />@19 5
<br />KC.©9988-2015 ACORD CORPORATION. All richt;
<br />AGORU 25 (ZUT 6/03) The ACORD name and logo are registered marks of ACORD
<br />newrequest
<br />51140258
<br />
|