Laserfiche WebLink
A� o CERTIFICATE OF <br />(ABILITY 114SURANCI: DATE(MMIDD/YYYY) <br />0 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO <br />DOES NOT AFFIRMATIVELY ORNEGATIVELY, <br />L 'ev�'�, RIGHTS UI 1)N I ECERTIFICATE <br />THE COVE 1A E AFF RDED <br />EXJ;F <br />BY T POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CO STI E C EETWEEN TF' d IG 1�1#`'1�CEii(e, A'Cq@k)0@ <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURE <br />the policy(ies) must be endor d. If SU 4TAN <br />the terms and conditions of the policy, certain policies may requir <br />e s e lit It <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />E: $ V H. <br />INSURANCE LAND INSURANCE SERVICES <br />PHONE .213-°dP -5505 a 213-388-7148 <br />4032 WILSHIRE BLVD <br />o; <br />ADURE S. INSURinNCELAND@GAMIL.COM <br />STE 309 <br />INSURERS AFFORDING COVERAGE NAICIt <br />LOS ANGELES CA 90010 <br />INSURERA: EVANSTON INSURANCE CO 35378 <br />INSURED <br />INSURERS: PROGRESSIVE INSURANCE CO <br />27804 <br />VALLEY MAINTENANCE CORPORATION <br />INSURERC:UNITED STATES LIABILITY INS CO <br />25895 <br />INSURERD: ICW GROUP <br />27847 <br />11759 TELEGRAPH ROAD <br />INSURERE:TRAVELERS CASUALTY AND CURETY CO <br />19038 <br />SANTA FE SPRINGS CA 90G70 <br />INSURERF: <br />UUVLK kal=5 CtR I 1 FICATE N I IMR FIR - o.aIuoc Tal uuu e_.e. <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 />INTR <br />TYPE OF INSURANCE <br />ADDL <br />INSO <br />SUB <br />Me <br />POLICY NUMBER <br />POLICY EFF <br />MWDDIYYYY <br />POLICYE% <br />MMIDDIYYYY <br />LIMITS <br />COMMERCIAL GENERAL UMBIDTY <br />3AA496137 <br />OB /13/2021 <br />06/13/2022 <br />EACH OCCURRENCE <br />$ 11000,000 . <br />CLAIMS -MADE © OCCUR <br />AMA ETORE ED <br />PREMISES Ea occurrence) <br />$ 100,000 <br />J <br />MED EXP(m one person) <br />$ 5,000 <br />PRIMARY NON-CONTRIBUTORY <br />ON GOINGAND COMPLETED OPS ENO <br />PERSONALBADV INJURY <br />$ 1,000,000 <br />A <br />X <br />X <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L <br />POLICY jE�a 1-1 LOC <br />PRODUCTS - COMP/OP AGG <br />$ INCLUDED <br />$ 25,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />03/12/2022 <br />03/1212923 <br />COMBINE03370309-1 <br />Ea acciideDtSINGLE LIMIT <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />B <br />ALLOWNED SCHEDULED <br />X <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />HIRED AUTOS AUT SWNED <br />PROPERTY DAMAGE <br />Per a ent <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />XL1578400D <br />05/02/2022 <br />05/02/2023 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />AGGREGATE <br />$ 5,000,000 <br />(-' <br />EXCESS LIAS <br />CLAIMS -MADE <br />DIED I I RETENTION$ <br />PRODUCTS-COM/OP AGG <br />$ 1,000,000 <br />WORKERS COMPENSATION <br />ANDfMPLOYERTLIABIUTY <br />WSA5037498-04 <br />OB /13 /2021 <br />09/13/2 D22 <br />(I PERSTATUTE ER µ <br />D <br />YIN <br />ANY PROPRIETORIPARTNEIVEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? Y❑ <br />NIA <br />X <br />E.L EACH ACCIDENT <br />$ 1, GOO, OOO <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISEASE - EA EMPLOYE <br />$ 11000,000 <br />E.L. DISEASE -POLICY LIMIT <br />$ 1, 000,000 <br />DESCRIPTION OF OPERATIONS below <br />E <br />CRIME <br />105620G59 <br />05/24/2021 <br />05/24/2022 <br />THIRD PARTY $1, 000, 000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule. maybe attached If mete apace Is required) Agreement Number : A-2021-043 <br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written contract, <br />agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City <br />shall be excess and noncontributory." <br />This Policy may be canceled by the Company by giving to the Insured and to the additional insureds Indic ated on the certificates of insurance <br />issued during the term of this policy, at least Thirty (30) days written notice of cancellation or in the case of non-payment of premium, at least <br />ten (10) days' written notice of cancellation." <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA, 4TH FLOOR <br />SANTA ANA. CA 92702 <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 />AUTHORIZED REPRESENTATIVE <br />1�49-el (�& <br />Cl 1988-201d <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />RlaleMRregallattDMeWt ' <br />REmEND&APPROVHJBY `+ <br />Now Risk Management Specialist <br />of <br />