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Last modified
6/15/2022 3:47:32 PM
Creation date
6/10/2019 1:44:52 PM
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Template:
Contracts
Company Name
VIDEO ENGINEERING SERVICES
Contract #
A-2019-074
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Council Approval Date
5/21/2019
Expiration Date
6/30/2020
Destruction Year
2025
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DANE= <br />t►� CERTIFICATE OF LIABILITY INSURANCE n2n7n� s <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />CERTIFICATE DOES NOTAFFIRMATIVELY OR NEGATIVELY All EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTEA 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 pollay(ies) must have ADDITIONAL WSURED provisions or be endorsed, <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endomement A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsements . <br />PRODUCER <br />Triton of Calif insurance Services, Inc. <br />2332 Auburn Blvd <br />Sacramento, CA 95821 <br />License #: OF417S7 <br />C;gV,C Chris Rud01 h <br />paawE (816Nie$4705 (ac a P (9181A85A198 <br />`� e: chria moninsuranee.Com <br />_ _ INSURER(0 AFFORDINDCOVERACE, <br />wsuRERa: Pnvdte nP lnlRv Insurance Co <br />NRIC• <br />_ <br />C� <br />INSURED ® { o—a) <br />TOM BYSTRY <br />DBA: VIDEO ENGINEERING SERVICES <br />14 APPOMATTOX <br />IRVINE, CA 92820 <br />SUPFRO: <br />wauREHc: <br />INSURER D: <br />NeuaeaE: <br />INSURERF: <br />G4YCNnUCO •.r=nnr•v.+,r o.+••,,...•.. ,.,..w...-.w.... <br />THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED <br />INDICATED. NOTPATHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED <br />a—y ._— SUSN <br />TVPE OF INSUMNOE POIJCY NUMBER <br />TO THE <br />POLICIES DESCRIBED <br />BY <br />INSURED NAMED <br />OTHER DOCUMENTWTH <br />HEREIN <br />PAID CLAIMS. <br />_... _... <br />ABOVE FOR THE POLICY PERIOD <br />RESPECTTO VMIICH THIS <br />IS SUBJECT TO ALL THE TERMS, <br />_ <br />.. Pago <br />02JO112019�0210112020 <br />P UCY P <br />UMn3 <br />LiR <br />A <br />COMMERCIALCENERALLuaILITY <br />CWM6.AWOa CIgCGUR <br />Y <br />Y <br />MP0004000005022 <br />EACHOWURRENCE <br />S 000000 <br />eft NT <br />P Lew1Lg aa—Eu� <br />_MED"P_LAn nnn pandm <br />S 1OO DDD <br />s 5000 <br />' <br />i <br />PERSONALAADVINJURY <br />S 1 000000 <br />pENLAGOREIOA�TE UNIT APPUE6 PER: <br />X PdJCYI�iE�CT' ❑ <br />OENEMLAGOREGATE <br />s 2.000,000 <br />PRODUCTS-COMPIOP AOG <br />S 100 000 <br />i <br />OTHER: <br />AUTOMOSLELWBIUn' <br />Ena�ds,I) NED M <br />3 <br />S <br />ANY AUTO <br />SCOILYINUAYIPecpnrsan) <br />BODILY INJURY(PnrztitlenU <br />9 <br />OWNED SCNEd1LEO <br />AUTOS ONLY AUTOS <br />AUIOa ONLY AUTOS ONLY <br />1 <br />j <br />'ROP— Rat TYGE <br />ni <br />S <br />3 <br />UMSPELW UPe <br />OOCUR <br />mcm OCCURRENCE <br />3 <br />AGORDOATE <br />3 ...__. <br />EXCESS UAe <br />GLAIMSMADE <br />DIED I I R DNS <br />WORNERSCOMPENSATION <br />ANDEMPLOYERS'WOILITY YIN <br />9AM0PRIErOPEXCLUDWE%ECUINE Y__!N. <br />OFRCEPReIS N")E%OLLICfDi <br />tNUWataM In NN} <br />O <br />3 <br />3 <br />NIA <br />, <br />'- <br />ELPAEASE-DENT <br />S <br />E.L DISEASE -EA EMPLOYE <br />3 <br />EL OISFAeE•POLICY DLNT <br />S <br />IL 3, aesrnbn viler <br />RIPTION qF OPEMmONe Gebw <br />DESCRIPVWN OPEPATIONSILOCAVMSIWHICLES(ACOR018; Atltli0onal RertarXe SehWule, mnynn SHtcheeNmom epdca is NgPindl <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; Its Officers, employees, agents and representatives <br />are named as additional insureds per CO2010 attached to this policy. The insurance is primary and non-contributorlK. <br />lke'30' vsae <br />CITY OFSANTAANA SHOULDANYOFTHEABOVEOESC fi$n'*Pb StmEhBEFORE <br />THE EXPIRATION PATE TNEREQFt TICEYa DIN <br />FINANCE& MANAGEMENT SERVICES AGENCY ACCORDANCE WITH THE POLICYPROVISIONSS <br />PURCHASING DIVISION C <br />2D CIVIC CENTER PLAZA M-15 ALIHORMEDREP *Plc ptl <br />Santa Ana, CA 92702 <br />ADORE) 26 (2016/03) The ACORD name and logo are registered marks of ACORDetl 6y CPR on February 07, 2010 at 02:58PM <br />
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