|
<br />I.
<br />
<br />ACORD
<br />'"
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />PRODUCER (909)735-5335
<br />OFI Preferred Insurance
<br />2027 Hamner Avenue
<br />NoreD, CA 92860-2604
<br />
<br />FAX (909)735-3758
<br />Services
<br />
<br />DATE (MMlDDIYYYY)
<br />
<br />03/17/2006
<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 />
<br />INSURERS AFFORDING COVERAGE
<br />
<br />NAIC#
<br />
<br />'NSURED PRESTIGE STRIPING SERVICES INC.
<br />353 N. CYPRESS ST.
<br />ORANGE, CA 92866
<br />
<br />tNSURERA: Safeco Business Ins.
<br />INSURERB: Mercury Casualty Insurance Co.
<br />INSURER c:
<br />INSURER 0:
<br />INSURER E;
<br />
<br />COVERAGES
<br />
<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 NSR TYPE OF INSURANCE POLICY NUMBER OATE"MMlDrS~r- DATE MMlDDIYY LIMITS
<br /> GENERAL LIABILITY 01 CG 768379-2 03/22/2006 03/22/2007 EACH OCCURRENCE , 1,000,00
<br /> X COMMERCIAL GENERAL LIABILITY I ~~~~~s fa occurence' , ZOO,OOC
<br /> I CLAIMS MADE []] OCCUR MED EXP (Anyone person) , 10,OOC
<br />A PERSONAL & ADV INJURY , I,OOO,OOC
<br /> -
<br /> - GENERAL AGGREGATE $ 2,OOO,00C
<br /> GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPtOP AGG $ 2,OOO,OOC
<br /> I rnPRO- n
<br /> POLICY JEer LOC
<br /> ~TOMOBILE LIABiLiTY COMBINED SINGLE LIMIT ,
<br /> ANY AUTO (Eaaccidenl) I,OOO,OOC
<br /> -
<br /> ALL OWNED AUTOS BODILY INJURY
<br /> - ,
<br /> ~ SCHEDULED AUTOS ACl1071675 04/29/2006 04/29/2007 {Per person)
<br />B
<br /> ~ HIRED AUTOS BOOll Y INJURY
<br /> ,
<br /> ~ NON-OWNED AUTOS (Peraccidenl)
<br /> - PROPERTY DAMAGE ,
<br /> (Peraccidenl)
<br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ,
<br /> ==J ANY AUTO OTHER THAN EA Ace ,
<br /> AUTO ONLY: AGG ,
<br /> ~ESS'UMBRELLA LIABILITY Recei ed By EACH OCCURRENCE ,
<br /> OCCUR D CLAIMS MADE :mta AnI ~ AGGREGATE ,
<br /> City of S ,
<br /> ==J DEDUCTIBLE ,
<br /> RETENTION , .un ,>1 ,
<br /> WORKERS COMPENSATION AND -l'"Inff "'" I TORY LIMITS I I OJ~-
<br /> EMPLOYERS' LIABILITY
<br />C ANY PROPR1ETORlPARTNERlEXECUTIVE Downtown Developr 'lent E.L. EACH ACCIDENT ,
<br /> OFFICER/MEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYE ,
<br /> If yes, describe under . L.,,__
<br /> SPECIAL PROVISIONS belON E.l. DISEASE - POliCY L:MIT $
<br /> OTHER "
<br /> -.
<br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS' I, '.'~ 1-...._\.' .',","l l'J ['
<br />o DAYS NOTICE WILL BE SENT FOR NON PAYMENT OF PREMIUM.
<br />ERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. __>~Z~'f /;j-
<br />OB: VARIOUS JOB LOCATIONS
<br /> , _c. . I c::..__.,'.,
<br /> '. .' ;;f.A.dj
<br /> ,:", <_-'i; \i /\tt::)) 'iC')'
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CITY OF SANTA ANA
<br />A TIN : ROCK GARCIA
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92701
<br />
<br />CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ~ MAIL
<br />~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />_KJI!IroOOI\IOOQXIlJlIUOOOO)lIlllIl!lOOX)lJlJQJlIl_XIIXXXX
<br />III~JI!(_!OOtJl)l(JlJlJtJl!llllJlJQJ()l___XXXXXXXXXX
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />
<br />ACORD 25 (2001/08)
<br />
|