Laserfiche WebLink
Client#: 51358 <br />4BLIEN <br />ACORD- CERTIFICATE OF LIABILITY INSURANCE <br />) <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />1DATE <br />0/30/07D <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />DeWitt Stern of California <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Insurance Services LLC oO / I <br />d (O <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />10969 Ventura Boulevard �I <br />A <br />Studio City, CA 91604 -CA <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />INSURER A: The Hartford -CA <br />Lien on Me, Inc. <br />465 N. Halstead St, #130 <br />Pasadena, CA 91107 <br />INSURER e: Lloyd's of London <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />INSRE <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM/DD/YY <br />POLICY EXPIRATION <br />DATE (MMIDDIYYI <br />LIMITS <br />A <br />GENERAL LIABILITY <br />72SBAAG7645DX <br />08/15/07 <br />08/15/08 <br />EACH OCCURRENCE $1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />PREMISEDAMAGES ( RENTED $300 000 �. <br />MED EXP (Any one person) $10,000 <br />CLAIMS MADE 51OCCUR <br />PERSONAL & ADV INJURY $1,000,009k <br />GENERAL AGGREGATE $Z 000 OO <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $2 00O 001P <br />X POLICY PRI- I <br />ECT LOC�'.._N <br />A <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />72SBAAG7645DX <br />08/15/07 <br />08/15/08 <br />COMBINED SINGLE LIMIT <br />$1 000,00Q <br />(Ea accident) , <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per person) $_ <br />X HIRED AUTOS <br />NON -OWNED AUTOS <br />.C► <br />BODILY INJURY $X <br />Per accident <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: AGG $ <br />A <br />EXCESS/UMBRELLA LIABILITY <br />X OCCUR ❑ CLAIMS MADE <br />72SBAAG7645DX <br />08/15/07 <br />08/15/08 <br />EACH OCCURRENCE $1,000,000 <br />AGGREGATE $110001000 <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />WC STATU- OTH- <br />ORY <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT $ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. DISEASE - EA EMPLOYEE $ <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT 1 $ <br />SPECIAL PROVISIONS below <br />B <br />OTHER Professional <br />ME0100019307 <br />03/25/07 <br />03/25/08 <br />Limit/Agg $1,000,000 <br />Deductible $5,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ' <br />The City of Santa Ana, it's agents, officers and employees are named as additional <br />insured's per the attached form. *10 days notice of cancellation for non payment of <br />premium. - <br />City of Santa Ana <br />Carolyn Richard <br />20 Civic Center Plaza (m-41) <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL FV6V*0Fj% MAIL *An DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />IMPowae b6hs10N(�'i M1ORAr»IfW <br />AUTdO RIZED�REPgESENT <br />P%%.%jMU Aa 1ZUU1/UG) 1 of 2 #151757 4GIN © ACORD CORPORATION 1988 <br />