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LIEN ON ME 2 - 2006
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LIEN ON ME 2 - 2006
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Entry Properties
Last modified
11/8/2017 10:20:57 AM
Creation date
5/26/2006 12:26:06 PM
Metadata
Fields
Template:
Contracts
Company Name
Lien On Me
Contract #
A-2006-112
Agency
Personnel Services
Council Approval Date
5/1/2006
Insurance Exp Date
8/15/2018
Notes
Workers' Comp expires 06/01/09
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CERTIFICATE OF LIABILITY INSURANCE CA-n!IWNY00MYY) <br />THIS CERTIFICATE IS ISSUED AS Aa MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER'nFlCATS 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. ff the certificate holder is an ADDITIONAL INSURED, the policy(ies) mast have ADDITIONAL INSURED Provisions or bo onuorsod, <br />If $USROGATiON IS WAIVED, subjoct to the terms and candit"sons Of the Pollcy, certaln Policlas may roquire an ondorsoment, A Statement on <br />this certlflcate does not confer rl Drs t0 the of rlii'ielte holder in lieu 01'swots endorsement#s). <br />PRODUCER <br />cpvrncr <br />NAri[: <br />TMJ INSURANCE AGENCYFaIiONF <br />-5560 ........... �..._. <br />jr�� . <br />�-E-MAL 8�$d6m55i;4 -_ - � e e;,... ffOiE�tt$+I6.5551 <br />2009 W Magnolia Blvd Ste C <br />BURBANK, CA 9i505 <br />_ INSURixR(S)AFFORIIINGCDItSIRA 8 NAI0A <br />r,GG;;E!3ATSUMrrAPPLIESPER: <br />f1 <br />INSURERA: SiateCompensEltlOnInsurance Fund 3x076 <br />INSURE <br />Lien On Me Inc. <br />1 rN5}3ReRS: II <br />- <br />INSURER C <br />OTI!mi <br />g <br />465 N. Halstead St. 10104 <br />� <br />Pasadena, CA 91109 <br />I[asuRERe: <br />• C'LliiEiIVEL7$ip7t-L {_Ih!li <br />v ivTrvly ty UrvIGGFS: <br />TRIS IS TO CERTIFY THAT THE P6LIC(C:S OF INSURANCE USTED BELOW HAVE BEEN ISSUED To Thi£ INSURE[) NAMED ABOVE FOR THF, POLICY PERIOD <br />sNDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR MER DOCUMENT <br />WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCF AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICE -ES. LIMITS SHOEIAN MAY HAVE BEEN REDUCED 13Y PAID CLAIMS. I <br />IFJSR Calm SUER <br />'rF TYPE (S=1N9iiliANGE f r. <br />— I S ayUl.ICV I:UM1".riER <br />I COMMERCIAL GENERAL LIABILITY —�� <br />_._.-- .-..-..._._... ... _.... <br />r'tlI_ICYCPF P1%1JDD EXI' T4 <br />h!M1YFIfrYYYY6 hiA7J0Q YYY EINIT5 <br />j <br />GLAIMS.MADE L I OCCUR <br />TACH =URRir; t <br />�-.� <br />. ............... ._._—_..,.,....._._.....»».. I <br />€ I iAGL1 £YA [;,ry si'e9;}Rr$fJn} .. .... <br />....__.e....,..._....___._... _.FRO. <br />._.».•.• - �.._ <br />f <br />F[:rt,�idhU;l� AI3VfL7.l4il�Y 5'__v,_._._._._._.. <br />r,GG;;E!3ATSUMrrAPPLIESPER: <br />f1 <br />Rnd_ <br />GEN1 <br />ECSiREGfT1< <br />— RM- _..._.... ..—........,�..._.—.,...M.....,.,...- <br />P�LIC1° 1..._J Ji:�C= LOCO+3 <br />i'r2�,:3td::75.Ct3WFii'Rt'�.s S .. <br />OTI!mi <br />g <br />RUFpMgeILELIAAILITY <br />� <br />I <br />l <br />• C'LliiEiIVEL7$ip7t-L {_Ih!li <br />$ <br />ANY,WTO <br />} <br />I <br />;s4114y INJURY (Pet parson) <br />i..._.-_, <br />5 <br />...... <br />OWNED SCHEDULED <br />ONLY ALT05 <br />1 8R;5r".Y INJURY (Per OOC#de,)ij <br />5 <br />HIRED <br />HIRED NON+OWNED <br />RUTGSONLY _.. AVT6gONLY <br />A _...... <br />S lY � V <br />i?erzccli�a�I)- <br />_ ..e <br />J <br />- .. <br />UMBRELLA LIAR _ CCCUR <br />EXCEBSLiA6 I <br />m.,_.. a CLP MS A:t�C�•. <br />� �...._—� <br />� <br />EAGw CUR -N $ _ <br />1 - <br />,..C�Yx�CAt1= ..,...�_3- <br />nrt� rIe dTlda <br />�i <br />F• . <br />Za �..�`..�-... <br />�WGIVERSCG[JPENSATION <br />BWIP <br />A <br />ANYAND <br />Rift7O (PARTIL1TY <br />PRgPRiETQFi/PFr"iTrvE$31c"XEL`41?]Va YIiS <br />t)F� 3C:}£trMt_rzt14R EXCLUL)ED7 �' NIA9202666E.L. <br />(tT.,na:a,ml'InNN) f <br />I <br />` <br />06101393 <br />06104178 <br />—.__.�.....-........_..._._... <br />EACi'1ACf1 iENi g 1 t?00 QCII3 <br />- — . <br />YPJt <br />it yes. descrihe�rttir,; t <br />I <br />=r_i'w....,__ <br />e: SEA :.I d I.OYEf3AS.._........._..._itI}{�I).(I00 <br />..- ,nL a r�SE <br />r7IP Vfn Of• C:PER:t'[C`+Y& bfildy __.._. t... -._ k <br />r <br />; <br />3 <br />€ <br />i <br />I <br />E.i. D15.4R.�sQ • f�{3i Ye Y iiast: ; S — -- - 1.Ii{ E}(} <br />r....._._ <br />DESCRIPTION OFOPERATIONS tLOCATIONSIVeHICLES(ACORD 10i,AddltlonalRamarksSchedule, may hoaflavhedifMomspnoa[srequlredl <br />30 days natice of cancellation for goer payment. <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Era CANCELLED 1115FORE <br />Ain, Samantha Lambert+ THE EXPIRATION BATE THEREOF, NOTICE mu BE ogLwEReD IN <br />20 Civic Center Plaza (m-44) ACCORDANCE IIIIITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92709 :AU:T1k:110t:k1Z:E0FR1FPRES;wNTA71v <br />t7196S-2119 ACORD C Pt1€3AT1C?N. All rig h#5 reeorvr d. <br />ACORD 25 (2015103) The ACORD name and logo are registered Marks of A-Ot2I3 <br />3' vyl- <br />
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