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HJELMSTROM & ASSOCIATES
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Entry Properties
Last modified
10/31/2018 3:56:09 PM
Creation date
9/6/2018 2:27:11 PM
Metadata
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Template:
Contracts
Company Name
HJELMSTROM & ASSOCIATES
Contract #
A-2015-158-01
Agency
PUBLIC WORKS
Council Approval Date
8/4/2015
Expiration Date
8/5/2019
Insurance Exp Date
1/1/1900
Destruction Year
2024
Notes
A-2015-158
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Allstate. <br />You re in good hands. <br />CERTIFICATE OF INSURANCE <br />Cl CW A02 10 11 <br />This certificate is issued for informational purposes only. It certifies that the policies fisted in this document have been issued <br />to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided <br />by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage <br />is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other <br />contract, such as between the certificate holder and the Named insured. The limits shown below are the limits provided at <br />the policy inception. Subsequent paid claims may reduce these limits. <br />Certificate Holder Named Insured: <br />CITY OF SANTA ANA RLS ENTERPRISES INC <br />20 CIVIC CENTER PLZ 25072 WILKES PL <br />SANTA ANA, CA USA 927014058 LAGUNA HILLS CA 92653-4926 <br />Automobile Uability <br />Insurer Name: Allstate Insurance Company <br />PolicfNumber <br />648807053 <br />Authorized Representative: <br />1 --Any Auto <br />Date: 01-25-18 <br />2 - Owned Autos Only <br />3 - Owned Priv. Pass. Autos Only <br />4 -- Owned Autos Other Than Priv. <br />Pass. Autos Only <br />5 - Owned Autos Subject to <br />No Fault <br />6 - Owned Autos Subject to a Compulsory UM Law <br />X 17 <br />-- Specifically Described Autos <br />X <br />8 - Hired Autos Only <br />9 - Nonowned Autos Only <br />Polic Effective Date: 02-01-2018 Policy Expiration Date: 02-01-2019 <br />I Imitsof <br />$1, 000,000 Combined Single Limit (each accident) <br />Insurance: <br />BI Per Person I BI Per Accident <br />I PD Per Accident <br />Description of Operations/LocationsNehicies/Endorsements/S cial Provisions <br />Interested Party Type: Additional Insured - Municipality <br />THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. <br />IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST <br />EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL <br />INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH <br />POLICY LANGUAGE OR ENDORSEMENT. <br />Producer. <br />GERALD E BROWN <br />Authorized Representative: <br />Date: 01-25-18 <br />6u114R-3 Cl CW A02 10 11 <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission <br />Allstate Insurance Company <br />Page 1 of 1 <br />Insure <br />REVIEWED BY: EUNICE HEREDIA (PG OF ) <br />
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