Laserfiche WebLink
ACOR" CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />12/28/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT 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 />Spectrum Risk Management <br />74 Discovery <br />Irvine, CA 92618 <br />CONTPRODUCER <br />NAME: Account Manager <br />aCNNo, Ext: 949-756-5730 FAX <br />No: 949-756-5740 <br />E-MAIL <br />ADDRESS: office@spectrumrisk.com <br />INSURERS AFFORDING COVERAGE NAIC # <br />1A18CGLO195681C <br />INSURER A: Navigators Specialty Insurance Co. 36056 <br />www.spectrumrisk.com OC77485 <br />INSURED <br />TSCM Corporation <br />TSCM Corp. Arizona <br />INSURER B: West American Insurance Company 44393 <br />INSURERC : National Union Fire Insurance Co. of Pittsbur h PA 19445 <br />INSURERD: Cypress Insurance Co. 10855 <br />Pappano Investment Group, LLC <br />17791 Jamestown Lane <br />Huntington Beach CA 92647 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 39619216 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, <br />INTR <br />OF INSURANCE <br />ADDLTYPE <br />JUM <br />WVQ SUER <br />POLICY NUMBER <br />MM/DDYLICY EFF <br />MMLDD EXP <br />LIMITS <br />A <br />�/ COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ✓ OCCUR <br />1A18CGLO195681C <br />1/1/2018 <br />1/1/2019 <br />EACH OCCURRENCE $1,00000_0 <br />DAMAGE O RE D <br />PREMISES Ea occurrence $100,000 <br />MED EXP (Any one person) $5,000 <br />✓ Deductible- $2500 <br />✓ Contractual Liability <br />PERSONAL & ADV INJURY $1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE $ 2,000,000 <br />POLICY ✓] JE 0 F—] LOC <br />PRODUCTS - COMP/OP AGG $2,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />BAW (19) 57 03 17 97 <br />1/1/2018 <br />1/1/2019 <br />COMBINED tSINGLELIMIT $1000000 <br />BODILY INJURY (Per person) $ <br />✓ <br />ANY AUTO <br />OWNEDSCHEDULED AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) $ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMAGE $ <br />Per accident <br />$ <br />✓ <br />Dedcutible-0 <br />C <br />UMBRELLA LIAB <br />�/ <br />OCCUR <br />BE 066322235 <br />1/1/2018 <br />1/1/2019 <br />EACH OCCURRENCE $5000,000 <br />AGGREGATE $5,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I ✓ I RETENTION $0 <br />$ <br />D <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />OF ICER/ EMB REXCLUDEANYPROPRIETOR/PARTNER/D?ECUTIVE ❑ <br />N/A <br />TSWC810195 <br />7/1/2017 <br />7/1/2018 <br />VSTATUTE ERH <br />E.L. EACH ACCIDENT $1,000000 <br />E.L. DISEASE - EA EMPLOYEE $1,000,000 <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / 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: EUNICE HEREDIA (PG I OF ) <br />%,r -m I Irn A I r- MULUCR %,ANLolI IA I IUN <br />Re: The Depot at Santa Ana -1000 E. Santa Ana Blvd. Santa Ana CA <br />Santa Ana Regional Transportation Center <br />C/O Santa Ana Public Works Agency <br />20 Civic Center Plaza, M-21 <br />Santa Ana CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE �/� -- <br />Jim Waterhouse '�/` <br />U 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />39619216 1 Ginnie 1 2018 All lines I Ginnie Bustamante 1 12/28/2017 4:35:30 PM (PST) I Page 1 of 3 <br />