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SOLOMON, STEPHEN
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SOLOMON, STEPHEN
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Last modified
4/23/2021 4:20:01 PM
Creation date
3/13/2019 8:23:01 AM
Metadata
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Template:
Contracts
Company Name
SOLOMON, STEPHEN
Contract #
N-2019-049
Agency
PLANNING & BUILDING
Expiration Date
2/12/2021
Insurance Exp Date
6/1/2021
Destruction Year
2026
Notes
WC NOT NEEDED AS VENDER HAS NO EMPLOYEES.
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I <br />CERTIFICATE OF LIABILITY INSURANCE I DATE JAIWD IY1'1'Y) <br />Q4J9ER 8 <br />THIS CERTIFICATE IS ISSUED AS A IVE.O OF INFORMATION AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THt <br />CERTIFICATE ROES NOT TEOFINSURANCE <br />AFFIRMATIVELY E NEGATIVELY AMCEND, C-.XTEND Ott ALTER. THE COVERJAGe FIPFORORO HY THE PULIGIE- <br />BELOW. THIS CERTIFICATE OF INSURANCE DOTS NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPRRTANT: if the Cerliflcato holdor is an ADDITIONAL INSURED, the pOiley(IRS) must have ADDITIONAL INSURED provisions or be endorser <br />If SUBROGATION IS WAIVED, subject to the terms and Cnndillons of the policy, certain poticles may require an endorsement A statement o <br />this Certificate does notconfer rights to the certificate holder In Ilan of such endnrsement(s}. <br />PRODUCER <br />COMPLETE EQUITY MARKETS INC <br />1190 Flex Court <br />Lake Zurich, IL 60047 <br />Hhe Cmnplme F.4uitq MOrkeis m,UranCn Ayarry, Inr. <br />INSURED <br />Stephen H. Solomon <br />INSURER A: <br />INSUft4j6 j <br />18$61 RidgBUVood Lane I,rsnReRB � .�w -"""" <br />VtllEtPark CA 92861 � -"""— <br />INSURERP <br />COVERAGF_S rconnrn rc u, ,. <br />ft wWWVN NUMBER: <br />THIS IS TO CERTIFY `MAT THE POLICIES OF INSURANCE USTEO BELOW HAVE SEEN ISSUED <br />TO THE INSURED NAMED ABOVE_ FOR THE POLICY PERIOI INDICATED, NO'TWTHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER <br />CERTIFICATE MAY HE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY <br />DOCUMENT WITH RESPECT TO WHICH TH]t <br />THE POLICIES DESCRIBED <br />EXCLUSIONS AND CONDITIONS OE SUCH POLICIES, LIMrIS SHOWN MAY HAVE BEEN <br />HEREIN 15 SUBJECT TO ALL THE TERME <br />REDUCED BY PAID <br />INSn _�.___._._.._�_._..__ ..— ._r.—_—.__.___ <br />�VN <br />L UDR <br />R TYPE GFINSURANCE POLICY NUMBBn <br />CLAIMS. <br />--.... _ ._...—�... <br />O�CYLT E FF - POUCYMP <br />CO"ERCLM. GENERAL LABILITY <br />g,�i"r11 RlIM10DIYYYYII LIMITS <br />CIAIMS.NADE E OCCUR <br />EACH OCCURRENCE S <br />'6AM"AZEYd Fl -- <br />- <br />6'-' <br />PREMISES�Ea vtturrenro)__ S <br />I <br />P_Sfa {Anq.mrt ,Lanonl_ is <br />.__. ... <br />PERSONAL b ADV INJURY S <br />GENLAGGREGAYE WES PER: <br />IT APPU <br />�_ <br />OTAPRU <br />POLtOY JcCT El IAC <br />aENERALAGGREGATE $ <br />-' <br />PROUD TS CCMPodPA6G $ <br />O-HER: ----�_ <br />, 8 <br />AUrOM08LL.E LIABILITY <br />-1 <br />I <br />COM9IHEU SIN LEL MIT <br />ANYAUTO <br />BODILYIHJURY(Pe'MMOe) <br />5 — _ — <br />—!OWNED SCNECULPO <br />AUTOS ONLY AUTOS <br />ZIM NUTMS <br />BOB-1YINJURY <br />ON LY I <br />� <br />- <br />tFROYeraERPYt[IIAMA'G'f' -� <br />E <br />UMBRELLA Me �BCCUR <br />`EACIi UCCURRENCE <br />1 —_ <br />ES <br />EXCESS LIAe CLAIMS`E <br />MAD <br />E _ <br />AGGREGATE. <br />�_ <br />,y <br />0.I RETENTIONb <br />`—.—"'..— <br />������I�0 <br />�_�._..�_ <br />I ' <br />WORKERS COMPENSATION <br />AND ETAPLQTER5 U0.91LIiV <br />LIABILITY <br />MFRLOYERO TIN <br />1 <br />PER OTII-� <br />T <br />1 $ <br />ANY LA <br />OFF9CERR.iL'hIBEREXdLL'UED'± ❑ <br />NIA <br />.ii....._I--_. <br />E.L. E\CN ACCIDtayT` <br />�$ <br />(Mya�+ndatory to NHl <br />— <br />_---------. <br />pf <br />E.L,D)iSF�SE_EA EMPLDYEd,$_ <br />nESGRIPTION CRERgT1CN5 imlaw <br />I <br />Professional Liability <br />E.L. OISEgSE-PUUCY LIIr1;T <br />Eac aim <br />000,000 <br />X <br />X ( <br />857634 <br />881olmil <br />D6totJ19 <br />Aggregate <br />$1,000,000 <br />bE9CRtPTNJt1 OF DPERATION5ILOCA'r10N$ I V£RICLEa (ACaRP Yat, Addjpnnal nrnrarrs Scnadulo, miry be aMCheN R mom space is mnulretl] <br />Subject to all policy terms, conditions, exclusions and endorsements. <br />The City Of Santa Ana is listed as an Insured <br />but only per the terms & Conditions of the endorsement generated and <br />additional <br />subject to all policy terms, Conditions, exclusions, and <br />endorsements. <br />CERTIFIGATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />The City Of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Civic Center ACCORDANCE WnH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana CA 92701 AUTIfORSMD REPRESENTA71VF <br />© 1988.2016 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2R76193) The ACORD name and logo are registered marks of ACORD <br />t`d 688b-1Z6-17II uowClaSLid UeL{dOJS <br />
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