DOWNTOWN INC.(DTI)-2018 - Laserfiche WebLink

Home Browse Search

AID 6r CERTIFICATE OF LIABILITY INSURANCE Dosi28/2o 8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Eddie QUIIIareS Jr. CONTACT NAME: Eddie QUIIIareS State Farm Agency 415 N. Broadway PHONE 714 617,7150. a No: 7 4.617.7158 -.._._ EMAIL AooREss eddie@eddieqinsurance.com Santa Ana, CA 92701 INSURERS AFFORDING COVERAGE NAICX INSURER A: State Farm General Insurance Company 25151 INSURED DOWNTOWN INC INSURER El: State Farm Fire and Casualty Company 25143 INSURER C: 200 N MAIN ST FL 2 INSURER D : SANTA ANA CA 92701 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 75-0450 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL BUSR POLICY NUMBER POLICY EFF tMMIDDnrYYY1 POUCYEXP (MMMDMYYILIMITS q GENERAL LIABILITY Y Y 92•CE-0933-0 O6/OS/2018 O6/0512019 EACHOCCURRENF $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx] OCCUR PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5.000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY PRO- LOC q AUTOMOBILE LIABILITY 1—Y] ❑ 75.0450-X94 0612812018 12/28/2018 Ea accideCOMINEntSINGLE LIMIT $ BODILY INJURY (Per person) $ 250,000 ANY AUTO ALL AUTOS OWNED SCHEDX AUTOS UTOS BODILY INJURY (Per accident) $ 500,000 HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ 100,000 Comp/Coll Ded $ 260 A UMBRELLA LIAB X OCCUR ❑Y FYI 92-CE-0781-7 06/05/2018 06/05/2019 EACH OCCURRENCE $ 1,000,000 I AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE DEO X RETENTION $ 10,000 1 $ B AND EMPLOY RS'LIABILIITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICE/MEMBER EXCLUDED? FYIN/A� 92-LH-2053.2 06/05/2018 06/05/2019 TOR WO suM TS X GER 1,000,000 E.L. EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 (Mandator, in NMI DESCRIPTION OPERATIONS beloe� E.L. DISEASE -POLICY LIMIT $ 1.000.000 A FIDELTY BOND ❑ ❑ 92-WV-6044-5 10/03/2017 10/03/2018 BOND -AMOUNT $ 500.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is returned) City of Santa Ana its officers, agents, employees and volunteers are named as additional insured. Additional Insured endorsement issued for certificate holder with Wavier of Subrogation and non-contributory CITY OF SANTA ANA 20 CIVIC CENTER PLAZA SANTA ANA, CA 92702 ATTENTION RISK MANAGEMENT BRIZA MORALES LearLea��au.Jc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. @ 1988-2010 ACORD CORPORATION. All ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012