Laserfiche WebLink
rrancme K. Francine R Villareal <br />Dace: 1020.09.02 <br />Villareal <br />,0:18:53 -W'00' <br />"� o CERTIFICATE OF LIABILITY INSURANCE <br />MWDN <br />OW31QO20 <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 endorsement(s). <br />PRODUCER <br />Aon Risk Services Northeast, Inc. <br />New York NY Office <br />One Liberty Plaza <br />165 Broadway, suite 3201 <br />New York NY 10006 USA <br />CONTACT <br />NAME: <br />PHONE (g66) 283-]122 FAX <br />(AIC. No. Eag: Ate. No : BDO) 363-0105 <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURED <br />LOS Angeles SMSA LP <br />dba verizon wireless <br />INSURERA: National union Fire Ins co_of Pittsburgh <br />19445 <br />INSURER B: AIU Insurance company <br />19399 <br />INSURER C: American Home Assurance Co. <br />19380 <br />1095 Avenue of the Americas <br />New York NY 10036 USA <br />INSURER D: New Hampshire Insurance Company <br />23841 <br />NSURER E: <br />NSURER F: <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 />LTR <br />TYPE OF INSURANCE <br />INSD <br />MD <br />POLICY NUMBER <br />MMIDDIYPOLICY YYY <br />POLICYEX, <br />LIMITS <br />MMERCIALGENERALUABILITY <br />CLAIMS -MADE ❑X OCCUR <br />TX--XC <br />Y <br />Y <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />DAMAGET RE T <br />PREMISES Ea occurrence <br />$2,000,000 <br />MED EXP (Any one person) <br />$10, 000 <br />U Coverage is Imluded <br />PERSONAL& ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />PRQ <br />X POLICY JECT LOC <br />GENERALAGGREGATE <br />$5,000,00(1 <br />PRODUCTS-COMPIOPAGG <br />$5,000,000 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />CA 4594298 <br />AOS <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />Ea accident)$1, <br />OOO, 000 <br />BODILY INJURY I Per mrsm) <br />A <br />ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED AUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />I <br />MA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per accident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />DEO <br />RETENTION <br />B <br />G <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandamryin NH) <br />It yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />wC045886576 <br />AOS <br />WC045886575 <br />CA <br />06/30/2020 <br />06/30/2020 <br />06/30/2021 <br />06/30/2021 <br />X PER STATUTE <br />OTFF <br />ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />EL DISEASE -POLICY LIMB <br />$1, 000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addi ional Remarks Schedule, may be attached if more space is required) <br />The above -referenced General Liability policy shall cover the tort liability of the certificate Holder assumed under the <br />underlying agreement between parties for which the certificate has been issued. City of Santa Ana, its council members, <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 by 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 />ri•'. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE i <br />POLICY PROVISIONS. <br />city of Santa Ana AUTHORIZED REPRESENTATIVE <br />Risk Management Division <br />20 civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 USA <br />cJ4ari <br />,t=.. , Wit rMwgesvdDiwdwl <br />©1988-2075 ACORD CO ��b®S' <br />APPROV <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ` _ ' Fu*c:wt P_ VJ±.cwL( <br />Rnk Mas,agemem: Analyst <br />