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LIEN ON ME 2 - 2006
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LIEN ON ME 2 - 2006
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Last modified
11/8/2017 10:20:57 AM
Creation date
5/26/2006 12:26:06 PM
Metadata
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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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A06 Dn CERTIFICA OF LIABILITY <br />INSU CE <br />DATE8/2005 <br />10/228/2005 <br />PRODUCER (213) 787-1100 <br />Frenkel 6 Co. , Inc. <br />725 South Figueroa St., <br />Suite 2200 <br />Los Angeles CA 90017- <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />Lic. #0098170 <br />Lien On Me, Inc.INSURER <br />P.O. BOX 91630 <br />Pasadena CA 91109-1630 <br />INSURER A: Hartford D/B <br />INSURER B: Tudor/Worldwide <br />C: <br />INSURER O'. <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 ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />ADD -L <br />IN RD <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MMIDD/YY <br />POLICY EXPIRAMN <br />DATE MM/DOIYY <br />LIMITS <br />A <br />GENERALLIABIUTY <br />72SBAAG7645 <br />08/15/2005 <br />08/15/2006 <br />EACHOCCURRENCE 3 1,000,000 <br />X COMMERCIALGENERALLIABILITY <br />CLAIMS MADE FK OCCUR <br />/ / <br />/ / <br />DAMAGE TO RENTED 300,000 <br />PREMISES (Ea occurrence $ <br />_ <br />MED EXP (Any oneperson) f 5,00-6 <br />PERSONAL B ADV INJURY 3 1,000,000 <br />EHL <br />GENERAL AGGREGATE S 2,000,000 <br />GEML AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGO S 2,000,000 <br />17 POLICY JEC FXJ LOC <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />72SBAAG7645 <br />08/15/2005 <br />08/15/2006 <br />COMBINED SINGLE LIMIT <br />(Eaaodeot) $ 1,000,000 <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />/ / <br />/ / <br />BODILY INJURY <br />(Per Pendn) S <br />X <br />X <br />HIRED AUTOS <br />NON-OWNEDAUTOS <br />/ / <br />/ / <br />BODILY INJURY <br />(Per socoam) $ <br />PROPERTY DAMAGE <br />IPeraw.dent) S <br />GARAGE UAINLITY <br />AUTO ONLY - EA ACCIDENT S <br />ANY AUTO <br />/ / <br />/ / <br />OTHER THAN EA ACC S <br />AUTO ONLY: AGG $ <br />A <br />EXCEBSAIMBRELLA LIABILITY <br />X OCCUR CLAIMS MADE <br />72SBAAG7645 <br />08/15/2005 <br />08/15/2006 <br />EACH OCCURRENCE 3 1,000,000 <br />AGGREGATE f 1,000,000 <br />3 <br />DEDUCTIBLE <br />/ / <br />/ / <br />$ <br />f <br />RETENTION 3 10,000 <br />WORKERS COMPENSATION AND <br />EMPLOYERS'UABILITY <br />/ / <br />/ / <br />TAT - TI{ <br />TORYLIMI S ER <br />_ <br />E.LEACHACCIDENT $ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />It yea, dosonbe uMer <br />E.L. DISEASE - EA EMPLOYEES <br />E.L. DISEASE - POLICY LIMIT S <br />SPECIAL PROVISIONS below <br />B <br />OTHER Professional <br />SPL0009778 <br />03/25/2005 <br />03/25/2006 <br />Limit/Aggregate 1,000,000 <br />Liability <br />/ / <br />/ / <br />Deductible Per Claim 5,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONBNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECML PROVISIONS <br />The City of Santa Ana, It's Agents, Officers and Employees are named as additional insureds per the attached form. <br />*Except ten days notice of cancellation in the avant of non-payment of premium. <br />rIUA IC KULUCK-- <br />- (714).647-5611 <br />ACORD <br />a <br />City of Santa Ana <br />Workers Compensation Claims <br />20 Civic Center" b9.a"L(M4dl)- <br />Santa Ana CA 92701- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />--EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL X1mMg4 MXM MAIL <br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, NW, <br />JEI6XX11fKXAfl616)6tiYXIXY11CAfAS1B@CNdCMEIfYI{`DfdM1YifD(X�D(AOS1061cX)I�l(XIiC6X)trINDfME <br />C <br />7886 <br />-tZIcUIXUNIUt btX YUHM5. INC. -(800)3211m35 Page 1 oft <br />
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