ACC O® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYVY)
<br /> �� 8/1/2024
<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 terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CON I ACI
<br /> NAME: Matthew Cowan
<br /> Sandco Services Inc dba The Julian Summers Insurance Agency INC.NNo,Ext): (310)361-5630 FAX
<br /> No):
<br /> 2629 Manhattan Ave E-MAIL r r sax co-I com •
<br /> ADORES.. })� ��by Angie NAIC#
<br /> Suite#270 31
<br /> IIermosa Beach CA 90254 IN RER T -2 ►fh 0 OF CT 25682
<br /> INSURED •'CAS CO OF AMER 25674
<br /> MULTI W SYSTEMS Angie Aceve �S 1 36161
<br /> ���.I�c�1 � 1 1 .4�.�n
<br /> 21) 5 STROZIER AVE INSW.ER : '
<br /> !NFJRER E: _07r001
<br /> EL MONTE CA 917332021 FluRER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 /> IN El-F POLICY EXP
<br /> R TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDY
<br /> LTR !YYYY) (MM DD/YYYY) LIMITS
<br /> K COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR UAMAGt I RbNItU
<br /> /� PREMISES(Ea occurrence) $ 100,000
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y Y Y-630-7J22389A-TCT-24 08/01/2024 08/01/2025 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> Px POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMI I
<br /> (Ea accident) $ 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED Y Y BA-3N112945-24-14-G 08/01/2024 08/01/2025 BODILY INJURY(Peraccent $
<br /> AUTOS ONLY AUTOOaccident))
<br /> -HIRED -NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY _AUTOS ONLY (Per accident)
<br /> Comp/Collision Ded $ 1,000
<br /> K UMBRELLA LIAB K OCCUR EACH OCCURRENCE $ 1,000,000.00
<br /> C EXCESS LIAB CLAIMS-MADE Y Y CUP-7J229094-24-14 08/01/2024 08/01/2025 AGGREGATE $ 1,000,000
<br /> DED RETENTION$ EBLIA $ 1,000,000
<br /> WORKERS COMPENSATION - PER OI H-
<br /> AND EMPLOYERS'LIABILITY Y!N /� STATUTE ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> B OFFICERJMEMBER EXCLUDED? Y N/A Y UB-712 3 0 1 24-24-1 4-G 08/01/2024 08/01/2025
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Re:SUBMERSIBLE PUMP REPAIRS
<br /> The City of Santa Ana,its officers,officials,employees,and volunteers are covered as additional insureds where required by written contract.30 day notice of cancellation
<br /> applies,10 day notice for non-payment of premium.Waiver of subrogation applies.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PR(\
<br /> 92 Risk ManagrmalEDivisi m
<br /> 20 Civic Center Plaza(M-30) AUTHORIZED REPRESENTATIVE . _ REVIEWED Et APPROVED 8Y:
<br /> P.O.Box 1988ri
<br /> o A41,z,Aewe e
<br /> I
<br /> Santa Ana,CA 92702 �� Risk Management Specialist
<br /> ©1988-2015 ACOR/
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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