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Last modified
5/17/2024 11:06:39 AM
Creation date
5/17/2024 10:43:04 AM
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Contracts
Company Name
JOE MACPHERSON FORD
Contract #
A-2024-029-02
Agency
Public Works
Council Approval Date
2/20/2024
Expiration Date
2/20/2027
Insurance Exp Date
1/1/2025
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CERTIFICATE OF LIABILITY INSURANCE <br />DA04E(MMIO NYYY) <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. <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 t <br />Angie <br />PRODUCER <br />'MARSH USA, LLC, evedo <br />ArI,16esi�evedoEMAL <br />ME <br />PHONE <br />a No : <br />Date: <br />B <br />n1a.CertRequestgmarsh.com Faz212941-4321 <br />NAIC#t <br />IABA ORDINGCOVEAGE <br />INSURER A: SafetyNational CasualtyCorporation <br />15105 <br />CN10236193&STNDGAG-24-25 I I <br />_ <br />INSURED <br />Joe Macpherson Fob <br />INSURER B <br />INSURER C : <br />DBA Autonalion Ford Tustin <br />20 Auto Center Drive <br />INSURER o <br />Tustin, CA 92782 <br />INSDRER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: ATL-005722656-02 REVISION NUMBER: 30 <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />POLICY NUMBER <br />POLICY EFF <br />(MMIDDPODW <br />POLICY EXP <br />IMMIDDNYYY)LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE x❑ OCCUR <br />CA 6676666 <br />01/OI12024 <br />01/01/2025 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 1,000,000 <br />MED EICP (Any one person) <br />$ <br />PERSONALS ADV INJURY <br />$ 1,000,000 <br />GENT <br />X <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY JECT LOC <br />GENERALAGGREGATE <br />$ 5,000,000 <br />PRODUCTS -COMP/OPAGG <br />S 2,000,000 <br />PremlProd Comp Dos <br />$ 501 MM EA OCC <br />oTHR: <br />A <br />AUTOMOBILE <br />LIABILITY <br />CA 6676666 <br />0110112024 <br />01101/2025 <br />CeBINEDtSINGLE LIMIT <br />$ 5,000,000 <br />X <br />BODILY INJURY (Par person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />X <br />BODILY INJURY (Per accident) <br />$ <br />X <br />HIRED NON -OWNED <br />AUTOS ONLY X AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />PER OTH- <br />ANDEMPLOYERS'LIABILITY YIN <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />OFFCERIMEMB RPEXCWDED1 ARTNERJEXECUTIVE <br />N/A <br />ELDISEASE -EA EMPLOYEE <br />$ <br />(Mandatory in Ni <br />II yes, describe under <br />OnOF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />A <br />GARAGE LIABILITY <br />CA 6676666 <br />01101I2024 <br />01/01/2025 <br />Any Auto Each Accident <br />5,000,000 <br />GARAGE KEEPERS LEGAL LIABILITY <br />GoNComp Coverage <br />5,000,000 <br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H mare space is required) <br />City of Santa Ana iislare included as additional insured where required by written contract with respect to general liability. Waiver of subrogation is applicable where required by writer contract with respect to <br />general liability. <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Risk Management Division THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PRE <br />Santa Ana, CA 92702 RiskMRIMgawdDhfYan <br />AUTHORIZED REPRESENTATIVE c•` , "= REVIEK'EDfi APPROV®BY: <br />A+.0 Aca44 <br />yN ® Risk Management Specialist <br />© 1988-2016 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />
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