Laserfiche WebLink
ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDD/YYYY) <br />F12x21/2018 <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 Spectrum Risk Management <br />74 Discovery <br />Irvine, CA 92618 <br />CONTACT <br />NAME: Account Manager <br />PHONE FAX <br />_(& No• 949-756-5730 AD No): 949-756.5740 <br />AOI RESS: office@s ep ctrumrisk.com <br />INSURER(S) AFFORDING COVERAGE I NAIC Y <br />INSURERA: Navigators Specialty Insurance Co. 1 36056 <br />www.spectrumrisk.com OC77485 <br />INSURED <br />TSCM Corporation <br />TSCM Corporation of Arizona <br />Pappano Investment Group, LLC <br />INSURER B: West American Insurance Company 44393 <br />INSURERC: Western World Insurance Company 13196 <br />INSURER D: Cypress Insurance Co. 10855 <br />17791 Jamestown Lane <br />Huntington Beach CA 92647 <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 46106928 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOIWITHSTANDING 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 />ILTR <br />TYPE OF INSURANCE <br />DLI <br />i INSD <br />VIVOUBRI <br />POLICY NUMBER <br />POLICY EFF <br />POLICY DDIYYYY <br />LIMITS <br />A <br />,/ COMMERCIAL GENERAL LIABILITY <br />LA19CGLO195681C <br />1/1/2019 <br />1/1/2020 <br />EACH OCCURRENCE S1,000,000 <br />CLAIMS -MADE MCCCUR <br />-DA, MTGETbRENT ED - <br />PREMISES (Ea occurrence $100,000 <br />MED EXP (Any one person) S5,000 <br />✓ Deductible- $2500 <br />✓ Contractual Liability <br />PERSONAL & ADV INJURY $1,000,000 <br />GEMLAGGREGATELIMIT APPLIES PER: <br />GENERAL AGGREGATE 52,000,000 <br />ET <br />a JC <br />PRODUCTS COMPIOPAGG $2,000,000 <br />S <br />OTHER: <br />B <br />AUTO <br />MOBILELIABILITY <br />BAW (20) 57 03 17 97 <br />1/1/2019 <br />1/1/2020 <br />ECOMBINED BcciISINGLE LIMIT S1,000,000 <br />BODILY INJURY (Per person) S <br />✓ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) 5 <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE S <br />Per a.,dent <br />t✓ <br />I s <br />Dedcutible- <br />C <br />�/ I <br />UMBRELLA LIAB <br />✓ OCCUR <br />GLX1001341-00 <br />1/1/2019 <br />1/1/2020 <br />EACHOCCURRENCE 55,000,000 <br />AGGREGATE 55,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />OED I ✓ I RETENTION -O <br />s <br />DWORKERS <br />COMPENSATION <br />AND EMPLOYIE71L. ILITY YIN <br />ANYPROPRIETORIPARTNER/EXECUTIVE <br />OFFICER/MEMBER£XCLUDEDT <br />NIA <br />TSWC913746 <br />7/1/2018 <br />7/1/2019 <br />,/ STATUTE ERH <br />E.L. EACH ACCIDENT $1,000,000 <br />E.L. DISEASE - EA EMPLOYEE $ <br />(Mandatory in NH) <br />If yes. describe under <br />DESCRIPTION OF OPERATIONS bebw <br />E.L. DISEASE - POLICY LIMIT S 1.000 000 <br />I <br />I <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />Re: The Depot at Santa Ana -1000 E. Santa Ana Blvd. Santa Ana CA <br />Dlnc, its officers, agents and employees and the City, its officers, agents and employees are additional insureds with respect to the general <br />liability per the attached blanket carrier form. Primary and non-contributory wording applies. <br />REVIEWED BY: aT EUNICE HEREDIA (PG 1 OF' <br />CERTIFICATE HOLDER CANCELLATION <br />Santa Ana Regional Transportation Center SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />San Santa Ana Public Works Transportation <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />C/O20 Civic Center Plaza, Works <br />Agency ACCORDANCE WITH THE POLICY PROVISIONS. <br />-21 <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />Jim Waterhouse r <br />©1988-2015 ACORD CORPORATION. All rights reserve <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />46106929 1 Ginnie 1 2019 GL/XS -AUT. 2018 WC 1 Ginnie Bustamante 1 12/21/2016 11:00:29 AN (PST) I Page 1 of 3 <br />