Laserfiche WebLink
rraneme K. Francine R. Villareal <br />Date: 1020.09.02 <br />Villareal <br />10:18:53 -07'00' <br />"ki. � CERTIFICATE OF LIABILITY INSURANCE <br />OB/WDDDATE(MMI00N20 V) <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 policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endomement(s). <br />PRODUCER <br />ADD Risk Services Northeast, Inc. <br />New York NV Office <br />One Liberty Plaza <br />165 Broadway, Suite 3201 <br />New York NY 10006 USA <br />CONTACT <br />NAME: <br />PHONE (866) 283-7122 FAX <br />(AIC. No. Exn AIC Nq : (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAICIf <br />INSURED <br />LOS Angeles SMSA LP <br />dba verizon Wireless <br />INSURER A: National Union Fire Ins Co of Pittsburgh <br />19445 <br />INSURER B: AIU Insurance Company <br />19399 <br />1095 Avenue of the Americas <br />New York NV 10036 USA <br />INSURER C. American Home Assurance Co. <br />19380 <br />INSURER D: New Hampshire Insurance Company <br />23841 <br />INSURER E: <br />INSURER F: <br />Crl\/COA(_CC /•e er,ern A— u, u,a nr•M. een <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. Limits shown are as requested <br />INSH LTR TYPE OF INSURANCE INSD MD POUCYNUMBER MMIOO FF MMLI LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Cl-AIMS-MADE F]OCCUR <br />XCU Coverage is Included <br />YY <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />DA T <br />PREMISES Ea occurm: e <br />E2, 000,000 <br />X <br />MED EXP (Any one person) <br />$10, 000 <br />PERSONAL a ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />PRO - <br />POLICY JECT LOC <br />GENERALAGGREGATE <br />$510001000 <br />PRODUCTS-COMPIOPAGG <br />$5,000,000 <br />OTHER' <br />A <br />AUTOMOBILE LIABILITY <br />CA 4594298 <br />ADS <br />O6/30/202006/30/2021rBODILY <br />BINED SINGLE OMIT <br />E.ccident <br />$1, 000, 000 <br />INJURY (Per person <br />A <br />X ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />OWNED SCHEDULED <br />AUHIRTOS <br />NON-OWNED <br />ONLY AUTOS ONLY <br />MA. <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021ERTY <br />LY INJURYAUTOS (Par acptlenq <br />DAMAGE <br />ccident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELIA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />DED1 <br />IRIETENTION <br />B <br />D <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY YIN <br />ANY PROPRIETOR <br />OFFICERIMEMBERIPARTNER I EXCLUDED?E%ECUrIVE E] <br />(Mandatory in NH) <br />It yes, describe and r <br />NIA <br />WC045886576 <br />ADS <br />WC045886575 <br />CA <br />06/30/2026 <br />06/30/202006/30/2021 <br />06/30/2021 <br />X <br />I PER STATUTE 1 <br />OTH- <br />R <br />EL EACH ACCIDENT <br />$1, 000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />EL .DISEASE -POLICY LIMIT <br />51,000,000 <br />I <br />DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES (ApDRp 101, Atld'Rional Remarks Schedule, may be aMachatl 8 more space is required) I <br />The above -referenced General Liability policy shall cover the tort liability of the Certificate Holder assumed under the i <br />underlying agreement between parties for which the certificate has been issued. City of Santa Ana, its council members, I <br />officers and employees are included as Additional insured with respect to the General Liability policy. The General Liability <br />policy shall apply as Primary and Non -Contributory Insurance to each Additional Insured listed herein. Where permitted 6y law, <br />the Named Insured parties listed herein waive all rights against City of Santa Ana, its council members, officers and employees <br />listed herein for recovery of damages to the extent these damages are covered by the above -referenced General Liability policy <br />and, as further limited by written contract between the parties. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 USA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />AUTHORIZED <br />0 <br />Z <br />R <br />C <br />Y <br />a <br />U <br />©f 988-2015 ACORD CO I!Wl <br />REVEWED 6APPROVED BY: <br />QACORD 25 (2016/03) The ACORD name and logo are registered mar <br />'��Ruk Managemen[Analys, <br />