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VIDEO ENGINEERING SERVICES (THOMAS BYSTRY) (3)
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VIDEO ENGINEERING SERVICES (THOMAS BYSTRY) (3)
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Last modified
9/25/2020 12:28:31 PM
Creation date
9/25/2020 12:26:03 PM
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Contracts
Company Name
VIDEO ENGINEERING SERVICES (THOMAS BYSTRY)
Contract #
A-2015-096-03
Agency
City Manager's Office
Expiration Date
12/31/2020
Insurance Exp Date
2/1/2021
Destruction Year
2025
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Phone:(714)647.5420 Fax:(714)647.6944 <br />ACORID" CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MVIDDNYYY' <br />0`112212020 <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 Pollcy(les) must have ADDITIONAL INSURED be <br />provisions or endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on <br />this certificate does not confer rights to the cenincate holder In lieu of auch endorsement a . <br />PRODUCER Triton of Calif Insurance Services, Inc. <br />5000 San Juan Avenue <br />Fair Oaks, CA 95626 <br />ME, T Chris Rudolph <br />PnxHONhl a (s161aes-1705 F �` . 91s -0199 <br />AeoRESS, chrisIRIbitoninsurance.corn <br />License#: OF41767 <br />.._� INSURER(9(AFFORDWG COVERAGE_ <br />NAICr <br />INSURER.: Mega <br />WSURF <br />TOM BYSTRY <br />INSURER a: <br />NSURERC: <br />DBA: VIDEO ENGINEERING SERVICES <br />14 APPOMATTOX <br />WSURERO: <br />IRVINE, CA 92620 <br />INSURER E. <br />INSURER <br />-- --- - mocrt: JV <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. NOTWTHSTANDING 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 />INSR TYPE OF INSURANCE LBIN POLICY OFF <br />POUCYNUYBFA 'M M uhns <br />A <br />X <br />COMYFRCW.OBJEMLUABH.IIY <br />y <br />MP0004009006721 <br />02101/2020 <br />02/01/2021 <br />EACHOCCUflHENce <br />i 1 000000 <br />cLAs1SNAOE CX OCCUR <br />E° <br />H 100D00 <br />SRe <br />S 5000 <br />MEOExP aY <br />PERHONALSAOVINIURY <br />S 100011DO <br />AGGREWTE UWi APPUEBPER' <br />2ENERALAGGREGATE <br />5 2000000 <br />GENL <br />POLICY ❑JET LCC <br />I <br />PROOVCTB-CPMPIOP AOO <br />i 2 ODD 000 <br />S <br />OTHER: <br />AUTOMOWLE <br />LIAYIDTY <br />COM& NGLE I <br />S <br />ANY AUTO <br />LYINIURY(Perpe ) <br />5 <br />OVE9 <br />ED <br />BOdLY INJURY (Persuidem <br />3 <br />AUr0S AUTOS <br />ONLY AUTOS <br />HIRED <br />HRFD <br />PROPERTY DA)MCk ...- <br />S <br />AUTORONLY AUTOS ONLY <br />AUT05O ONLY <br />$ <br />UMBRELLA LWa <br />OUR <br />EACH OCCURRENCE <br />$ <br />EACEBB LIAR <br />LUwSMADE <br />AGGREGATE <br />$ <br />RETENTIONS <br />5 <br />PER OTK <br />.AND EMPLOYERY LIA&CITY <br />AND EMPLOnW UAWLIT <br />ANY PRDPNETOPRAATNEP,EYECIRIVE YIN <br />E.1- EACH ACCIDENT <br />i <br />OFFICERAFMHER ESCLLDEOT <br />NIA <br />EL DISEASE EA EMKOYE1 <br />5 <br />(Menaefwyin NN) <br />IIYes. EOWW uneer <br />EL DiGEiMIE-POLICY LIMIT <br />i <br />OESCRImION OF OPFJUTIOHSAebw <br />DESCRIPTIONOF OPFnAT10N51 LOCARONH I VEmrU en IACOPO 151, Ae6Eora1 gmY,SY HCMduY, meY M elYCMe ilmon Brace Ie rtW Me) <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 CG2010 attached to this policy. The Insurance is primary and non-contributory. <br />Certificate of Insurance shall provide thirty (30) day prior written notice of wnceilatlon <br />REVIEWED A APPROVED <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th-f <br />SANTA ANA, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ANC11E ACEVEdO A11"O1'� <br />1988-201S ACORD <br />Avvw zo ILUI must Tne ACOI10 name and logo are registered marks of ACORD <br />PMted by CPR on January 22. 2020 at 11:54AM <br />
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