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INTERNATIONAL BUS LINES, INC, - 2017
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INTERNATIONAL BUS LINES, INC, - 2017
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Last modified
4/28/2022 9:27:15 AM
Creation date
10/31/2017 3:24:12 PM
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Contracts
Company Name
INTERNATIONAL BUS LINES, INC,
Contract #
A-2017-261
Agency
PUBLIC WORKS
Council Approval Date
10/3/2017
Expiration Date
10/2/2018
Destruction Year
2023
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.-� Policy Number. 73APS073685 Date Entered: 08/17/2017 <br />IF CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIOOln-M <br />10/24/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFUM11VELY 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 1NSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the tenns and conditions of the policy, cortain policies may require an endorsemont. A statement on <br />this certificate does not confer rights to the certificate holder In Ilou of such endomement(s). <br />PRODUCER Interstate Trans Insurance Broker Inc. <br />P.O.BO]C 911094 <br />Commerce, Ca 90091 323-728-0003 <br />vN,0NTACT Sa= SX #OG22050 <br />PHONE . (323) 728-0003 323) 888-2331 AA1C No <br />IrMAIL it3b2O000aol. com L:Lc# OG22050 <br />-AMBESS <br />INSURER S AFFORDING COVERAGE <br />NAICN <br />1W A•AM&= SPECIALTY =SURANCE COiPAW <br />17159 <br />INSURED xxTo22iA.TION" BCTS X<nws ANC <br />INSURER 0:IM ICML LIABILITY G SIR$ =SUPAi;= COAT <br />20052 <br />INSURER C:B SCE COMLe.ANY <br />37362 <br />2088 'REST BII+LCR'EST DR B208 <br />N>3YIBOR7L PARR, CA 91320 <br />INSURERD: <br />35076 <br />INSURERE• <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: Rivisiom NLIMFrER- <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 POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LIR <br />TYPE OF INSURANCE <br />SUER <br />POLICYRUMBER <br />PM CYEFP <br />POIDDA111M <br />LIMITS <br />A <br />CON15UMIALGENERALUABILITY <br />CLAIMS -MADE ® OCCUR <br />X <br />CXP322974 <br />07/02/2017 <br />07/02/2010 <br />EACH OCCURRENCE <br />$2,000,000.00 <br />EMI ® <br />$ 500,000.00 <br />s 5,000.00 <br />PERSONAL & ADV INJURY <br />$ <br />GEM AGGREGATE LUdITAPPLESPER: <br />POLICY ❑ im LOD <br />OTHER: <br />GENERA.AGGREGATE <br />$2,000,000.00 <br />PRODUCTS -COMPIOPAGG <br />S <br />s <br />B <br />AUTOMOBILE LIABILITY <br />ANYAum <br />OWNED K71 AUTOS ONLY AUTOS <br />AUED OSO <br />ONLY A ONLY <br />X <br />73APSO73685 <br />06/22/2017 <br />06/22/2019 <br />INGLE acrtdantl IMff <br />65,000,000.00 <br />BODILYINJURY(Perpersat) <br />E <br />BODILY INJURY(Paraceldent) <br />S <br />CWRW GE <br />W <br />$AUTOS <br />E <br />C <br />UMBRELLA LIAR <br />EXCESS UAS <br />OCCUR <br />CLAIMS -MADE <br />x <br />XDBW7268517 <br />EXCESS GLIMIiAL LTAB <br />08/3.6/2017 <br />7/02/20x8 <br />EACH OCCURRENCE <br />$ 3, 000, 000. 00 <br />AGGREGATE <br />$ <br />DED I I RETENTION <br />EXESS FIRE LGL <br />$ 500,000.00 <br />Li <br />WORKERS COMPENSATION <br />AND EMPLOYERS LIABILITY <br />ANYPROPRIEf "ARTNg1RMCUTNE YIN <br />OFFtCEWMEMSEREXCLUDEC? Q <br />(Mandatary In NH) <br />tfyyaa6 d06txWaut" ' <br />DE.SORIPTIONOFOPERAT{ONSbelow <br />N/A <br />9170728 <br />06/19/2017 <br />06/19/2013 <br />- . - <br />E.LEACHACCtDENT <br />E L. DISEASE -EA EMPLOYEE <br />g1,000,000.00 <br />$1, 000, 000. 00 <br />E.L. DISEASE -POLICY LIMIT <br />51,000,000.00 <br />DESCRIPTION OF OPERATIONS/ LOCATIONS! VEHICLES (ACORD 101, AdsOUonal Remand Schadula, maybe attaches! Umom apaca, Is mgalmd) <br />Commercial Livery Packaged Policy. <br />*** certificate holder is named as additional insured *** <br />New Location: SANTA MM, CA 92701 <br />l E\�€EWED BY: 6� EUNICE HEREDIA (PG OF <br />.._... _._..� _ N __. _---...... <br />SANTA ANA XMGIONAL TRANSPORT. <br />1000 E. SANTA AAA. SLVD.SUMTE <br />SANTA A., CA 92701 <br />VAX-714-565-2692 <br />S AGENCY <br />TION CENTER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />108 THE EXPIRATION DATE THEREOF, NOTICE WIU. BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Sam LC xMM xxc <br />G <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <br />Ail rlahts raservnrl <br />Produced usina Fo=s Bass Plus software. www.FormsBoss.com: Imoresslve Publishina 800-208-1977 <br />
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