|
A v� CERTIFICATE OF LIABILITY INSURANCE
<br />Il
<br />O 07/25/00/
<br />0 7/2 5120118
<br />I 8
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
<br />AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES
<br />NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS
<br />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
<br />certificate holder in lieu of such endorsements .
<br />PRODUCER
<br />CS&SIEDGEWOOD PARTNERS INS CENTER
<br />PO BOX 968489
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />(AIC, No, El
<br />LAKE MARY, FL 32746-8989
<br />EMAIL
<br />Phone - 877-724.2669
<br />ADDRESS:
<br />Fax - 877.763.5122
<br />INSURERS) AFFORDING COVERAGE NAIC p
<br />INSURER A: Valley Fore Insurance Company 20508
<br />EACH OCCURRENCE $ 1,000,000
<br />INSURED
<br />TOWNSEND PUBLIC AFFAIRS, INC.
<br />INSURER B
<br />1401 DOVE ST STE 330
<br />INSURER C:
<br />INSURER D: Continental Casualty Company 20443
<br />NEWPORT BEACH, CA 92660
<br />INSURER E,
<br />MED EXP AO one 10,000
<br />person) $
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 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 INDICATED, NOTWITHSTANDING
<br />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
<br />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
<br />CLAIMS.
<br />Was
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY F
<br />MMIDOIYYYY
<br />POLICY EXP
<br />MMIDOA'YYY
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,000
<br />CLAIMS -MADE ® OCCUR
<br />DAMAGE TO RENTED $ 300,000
<br />PREMISES Ea occurrence)
<br />MED EXP AO one 10,000
<br />person) $
<br />A
<br />Y
<br />N
<br />6021178995
<br />08/3112018
<br />08/3112019
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER
<br />POLICY PRO- LOC
<br />JECT
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS - COMP/OPAGG $ 2,000,000
<br />OTHER
<br />AUTOMOBILE LIABILITY
<br />CO
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />accident
<br />BODILY INJURY (Per person) $
<br />ANY AUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />N
<br />N
<br />6021178995
<br />08/3112018
<br />08/3112019
<br />BODILY INJURY(Per accident) $
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />(Per Sootily
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE 5,000,000
<br />AGGREGATE 5,000,000
<br />D
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />N
<br />N
<br />6021179581
<br />08/31/2018
<br />08131/2019
<br />DED I >< RETENTION $ 10,000
<br />WORKERS COMPENSATION
<br />PER
<br />OTH-
<br />AND EMPLOYERS' LIABILITY
<br />STATUTE
<br />ER
<br />E,L, EACH ACCIDENT
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
<br />OFFICER/MEMBER EXCLUDED?
<br />N/A
<br />(Mandatory In NH) ❑
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />-
<br />E . DISEASE - EA EMPLOYEE
<br />E,L, DISEASE- POLICY LIMIT $
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if morespace Is required)
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are added as an additional insured's as provided in
<br />the blanket additional insured endorsement as it pertains to work being performed by the named insured under written contract.
<br />Waiver of Subrogation applies. Cancellation is per policy provisions.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />20 Civic Center Plaza (M-31) PO Box 1988
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana, CA 92702
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUpTTHHIORIZpEyD� REPRESENTATIVE
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
|