|
Client#: 6715
<br />SECTSECU
<br />ACORDTM CERTIFICATE OF LIABILITY INSURANCEDATE
<br />(MMIDDIYFYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />2/14/2013
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />EdgerwNAME:
<br />Partners Ins. Center
<br />?NONE 949-263-0606 FAx
<br />Lic#OB 9
<br />Lic#0629370 949.263-0606
<br />AIC No, Ext :INC, No
<br />E-MAIL
<br />19000 MacArthur Blvd. Penthse FI.
<br />ADDRESS:
<br />FREMISEM Ea Eccurrence $100000
<br />Irvine, CAA 92612
<br />926
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC0
<br />INSURER A: Philadelphia Indemnity Insuranc
<br />18058
<br />INSURED
<br />n Security Inc. A / A® — /C2
<br />�1/
<br />INSURER B: XL Specialty Insurance Co.
<br />37885
<br />INSURER C:
<br />7633 I
<br />7633 Industry
<br />Pico Rivera, CA 90660
<br />INSURER D:
<br />GENERAL AGGREGATE $2,000,000
<br />INSURER E:
<br />INSURER F:
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<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 />LTR
<br />TYPE OF INSURANCE
<br />NSRL
<br />WVD
<br />POLICYNUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />PHPK948551
<br />11/22/201211/2212013EACH
<br />OCCURRENCE $000000
<br />1
<br />FREMISEM Ea Eccurrence $100000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE 19 OCCUR
<br />MED EXP (Anyone person) $5,000
<br />PERSONAL &ADV INJURY $1,000,000
<br />X BI/PD Ded:5,000
<br />GENERAL AGGREGATE $2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGS $2,000,000
<br />POLICY F7 PE' LOC
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />PHPK948551
<br />11/22/2012
<br />11/22/201
<br />COMBINED SINGLELIMIT
<br />Eaeccident $1,000,000
<br />BODILY INJURY (Per person) $
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOB
<br />BODILY INJURY Per accident $
<br />( )
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE $
<br />Per accident
<br />$
<br />A
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />79345225
<br />11/22/2012
<br />11/22/201
<br />EACH OCCURRENCE $1,000,000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />AGGREGATE $1000000
<br />DED X RETENTION$10000
<br />$
<br />B
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y/N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />INIA
<br />RWD5000366
<br />02/12/2013
<br />02/12/201
<br />XWC STATLL OTH-
<br />0 L ITED
<br />EL EACH ACCIDENT $1,000,000
<br />EL.DISEASE-EAEMPLOVEE $1,000,000
<br />(Mandator, in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
<br />Certificate Holder is named Additional Insured as respects to GeneralCO `S
<br />Liability, as required by written contract, per attached form.
<br />�� S� ��tO Bey
<br />C;m
<br />gF15
<br />CITY OF SANTA ANA
<br />ATTN: Ms. Christine Calderon
<br />20 CIVIC CENTER PLAZA, PO BOX
<br />1988-M-13
<br />Santa Ana, CA 92701
<br />ACORD 25 (2010/05) 1 Of 1
<br />#S263134/M262666
<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 />© 1988.2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />PATI
<br />
|