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ACORO® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDNYYV)
<br />07/23/2019
<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
<br />CONTCT
<br />NAME: Marie Parks
<br />Centerpointe Insurance Services, Ltd
<br />HONE.FAX
<br />C Ed (800)451-8766 ac No: (805)384-8036
<br />807 CAMARILLO SPRINGS RD
<br />oDliMs. mariep@cpiins.00m
<br />i
<br />INSUREIUS) AFFORDING COVERAGE
<br />NAIL e
<br />STE B
<br />CAMARILLO CA 93012-9464
<br />INSURER A: AMGUARD INSURANCE COMPANY
<br />42390
<br />INSURED
<br />INSURER B
<br />MetroPm Road Selvim, Inc.
<br />INSURER C:
<br />INSURER D :
<br />2550 S Gainsay Street
<br />INSURER E:
<br />Santa Ana CA 92707
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: CLI971501542 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 />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVO
<br />POLICY NUMBER
<br />MIN
<br />WD
<br />LIMITS
<br />x
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAMS -MADE ❑X OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />PREMISES Eaoe:umenoe
<br />$ 100,000
<br />MED EXP Any one person)
<br />$ 5,000
<br />PERSONAL a AM INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />K2GP006729
<br />07/24/2019
<br />07/24/2020
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />x POLICY ❑ JPEGT LOC
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS All
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED -SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURYIPerperson)
<br />$
<br />ANY AUTO
<br />A
<br />OWNED x SCHEDULED
<br />AUTOS ONLY AUTOS
<br />Y
<br />K2GP006729
<br />07/24/2019
<br />07/24/2020
<br />BODILY INJURY (Par accident)
<br />$
<br />X
<br />HIRED x NON-0WNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />accident
<br />$
<br />Uninsured motorist BI
<br />s 1.000.000
<br />UMBRELLA Lim
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEO
<br />I I RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNEWEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED)
<br />NIA
<br />P TII-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />$
<br />(Mandatory in NH)
<br />Ifyes, descdbeurder
<br />DESCRIPTION OF OPERATIONS Wlaw
<br />E.L. DISEASE -POLICY LIMIT
<br />$
<br />ON -HOOK /CARGO
<br />LIMIT PER SCHED VEH:
<br />$100,000
<br />A
<br />K2GP006729
<br />07124/2019
<br />07/24/2020
<br />DEDUCTIBLE:
<br />$2,500
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (AOORO 101, Addl4onal Remarks Schedule, may as attached If more space Is required)
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written
<br />contmct, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance
<br />Carried by City shall be excess and noncontributory
<br />A) Garagekeepers Legal Liability: 1) 2550 S. Garnsey St., Santa Ana, CA 92707 - $ 500,000 limit; 2)16212 Construction Cir., Irvine, CA
<br />92606 - $ 500,000 limit; 3) 957 W. 17th St., Costa Mesa, CA 92627 - $ 500,000 limit. Should any of the above described policies be Canceled
<br />before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named below,
<br />but failure to do so shall impose no obligation or liability of any kind upon the Insurer, Its agents or representatives
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
<br />REVrr��IE���W'ILE,$ & APPROVETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />BEFORE
<br />CityOf Santa Ana Risk Manag�h$N$b16i0T1 CEMENT DIVISI NACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />4th Floor 2019 AUTHORIZED REPRESENTATNE
<br />Santa Ana J4 A 92702 " \a'`-' (" t
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<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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