Laserfiche WebLink
A-2018-158-01 <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATEo612zJ2n020OYYYT <br />oze <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 poltcy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terns 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 />MARSH USA INC. <br />1050 CONNECTICUT AVENUE, SUITE 700 <br />CONTACT <br />INC PHONE FAX "+ --•- <br />VA" <br />WASHINGTON, DC 20036.5386 <br />INSURER(SI AFFORDING COVERAGE <br />NAICIs <br />INSURER A: ACEAmerican Insurance Company <br />22667 <br />CNI02986235Sercc-GA 20 <br />INSURED Bendel Inc. <br />INSURER B: AGEurope Ltd. <br />INSURER C : ACE Fire Underwriters Co <br />20702 <br />12930 Woddgale Drive <br />Suite 600 <br />Herndon, VA 20170 <br />INSURER 0: <br />NSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: CLE-006499800-12 REVISION NUMBER: 14 <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 />INSRI" <br />TYPE OF INSURANCE <br />POLICYNUMBER <br />MMI�DYEFF <br />POLICY UP <br />LIMITS <br />A <br />X I <br />COMMERCIAL GENERALLWBILIrY/ <br />CLAIMS -MADE OCCUK <br />G23866456009 <br />IN3112019 <br />fl i3Ti2620 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />PREMISES ma o� rta6 e <br />S 500,000 <br />MED EXP (My one anon <br />s <br />PERSONAL S ADV INJURY <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />X POLICY �JECOT EILOC <br />GENERALAGGREGATE <br />S 2,000,000 <br />PRODUCTS - COMPIOP AGO <br />S 2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOSILELIABILRY <br />CALH26285360 <br />1013112019 <br />10MO20 <br />COMBINED SINGLE LIMIT <br />lEfeacidentl <br />S 1,000,000 <br />X <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per person) <br />S <br />BODILY INJURY Par acd"enD <br />S <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMAGE <br />S <br />S <br />UMBRELULUB <br />OCCUR <br />EACH OCCURRENCE <br />s <br />AGGREGATE <br />$ <br />FXLE33 UAB <br />CLAIMSAIAOE <br />DED RET <br />I.,1 <br />A <br />WORKERS COMPENSATION <br />WLRC6745618A(ADS) <br />10/31R020 <br />X STERTUT OTI1 <br />A <br />D <br />AND EMPLOYERS' LIABILITY <br />ANYPROPRIETORIPARTNERIEXECUTNE Y/N <br />OFFICERIMEMREREXCWDED9 <br />(Mandatory, In NH) <br />NIA <br />WCUC67456269 (OH) <br />SCFC67456221(WI) <br />O6(JO12020 <br />067d012020 <br />1 1/2020 <br />10131020 <br />.L EACH ACCIDENT <br />S 1000 G00 <br />E.L. DISEASE -En EMPLOYE <br />S t,000,000 <br />H yyeeae de.cdhurul <br />DESdRIPTION OF OPERATIONS below <br />F.L. DISEASE -POLICY LIMIT <br />S 1000000 <br />B <br />SERCO GROUP PROFESSIONAL <br />7952631 <br />1OW/2019 <br />10131020 <br />LIMIT <br />1,000,000 <br />(LIMIT SHOWN IS IN <br />'GREAT BRITISH POUNOSI' <br />RETENTION <br />500,000 <br />DESCRWTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1D1, Addldonal R.marka Schedule, may ba.ma h" N more apace ie reeuhd) <br />The City, Its ofters, employees, agents, volunteers and representatives are Included Ss Additional Insured under the General Liability and Auto Liability policies where required by wn6en contract Coverage is <br />Primary and Non-Conitlbutory. The Umbrella/Excess Liability policy provides coverage over the underlying General liability and Auto Liability policies. 30 Days Notice of Cancel ation and Notice of Material Change <br />sperm as required by written contract <br />CERTIFICATE HOLDER ___ CANCELLATION <br />City of Santa Ana <br />Risk Management Division <br />20 Ovid Center Raga <br />Banta Ana, CA 92701 <br />n/ By Risk MANAGEMENT DIVISION <br />82020 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Q <br />_ <br />Af REPRESENTATIVE <br />— <br />o/ Marsh USA Inc. <br />Marsh S Inc. <br />ANGIE ACEVEdo <br />Manashi Mukhodee <br />© 1988-2016 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />f <br />