Laserfiche WebLink
WITTENT -Ol <br />- `'�'��O® G'ERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM /DD/YYW) <br />6/1 5/20'1 1 <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 pollcy(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 Ileu of such andorsement(s). <br />PRODUCER <br />Walls Fargo Insurance Services USA, Inc. <br />NAMEACT Tracy Dolan <br />PHONE g16 231 -1757 ac No : 916 231 -1868 <br />CA DOI Lic. #OD08408 (9'16) 23'1- '174'1 <br />11077 Cobblarock Drive, Suite lOO <br />E -MAIL trac Bolan wallsfar o.com <br />ADDRESS: Y� @ 9 <br />Rancho Cordova, CA 95670 -6049 <br />INSURERS AFFORDING COVERAGE <br />NAIG N <br />Hartford Casual Insurance Com an <br />INSURER A : tY P Y <br />29424 <br />INSURED Wittman Enterprises, LLC <br />INSURER B : National Fire Insurance Company of Hartford <br />20478 <br />INSURER c : Evanston Insurance Company <br />35375 <br />PO Box 269110 <br />INSURER D <br />INSURER E <br />Sacramento, CA 95826 <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 1875443 REVISION NUMBER- moo r,olr.... <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />MM /DD /VYYY <br />POLICY EXP <br />MM /DD /YYYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />575 BAAT6490 <br />07/01 /2011 <br />07/01/2012 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />DAMA E E ED <br />PREMISES Ea occurrence <br />$ 300,000 <br />MED EXP Any one parson) <br />$ X0,000 <br />CLAIMS -MADE � OCCUR <br />PERSONAL B ADV INJURY <br />$ 2,000,000 <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GEN'L AGGREGATE <br />LIMIT APPLIES PER: <br />PRODUCTS - COMP /OP AGG <br />$ 4,000,000 <br />X POLICY <br />PRO LOC <br />$ <br />B <br />AUTOMOBILE <br />LIABILITY <br />84012487490 <br />07/01/2011 <br />07/01/2012 <br />COMBINED SINGLE LIMIT <br />LEa accident) <br />1,DOq wo <br />X <br />_ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per acdtlent) <br />$ <br />X <br />NON -OWNED <br />HIRED AUTOS X AUTOS <br />PROPERTY DAMAGE <br />Par accitlanl <br />$ <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />57S BAAT6490 <br />07/01/2011 <br />07/01/2012 <br />EACH OCCURRENCE <br />$ z,000.000 <br />AGGREGATE <br />$ 2,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X RETENTION 10 000 <br />WORKERS COMPENSATION <br />WC STATU- OTH- <br />AND EMPLOYERS' LIABILITY Y / N <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOR/PARTNER/EXEC UTIVE <br />OFFICER/MEMBER EXCLUDED? � <br />(Mantlatory In NH) <br />N / A <br />�— <br />''� <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />� <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />C <br />Prof Liability <br />E084 M� <br />/01/2012 <br />$f ,000.000/$z,000,000 <br />�y �+�r <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Atlditional Ramarka Schedule, If more apace fs required) <br />Certificate holder named additional insured par attached form SS0008 04/05, pages 18 -20. <br />`10 day notice applies if cancelled for non - payment of premium. <br />IiCK l lrlliA l C r10LIJCK GANG CLLAT ION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />1439 BfoadWay ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE fj <br />Yew._ <br />The ACORD Hama and loco era raaistarad marks of ACORD CJ 1988- 20'IOJACORD CORPORATION_ All rinhfa rwxnrvwd_ <br />ACORD 25 (2010/05) I IIIIIII III IIIIIII IIII VIII 111111 IIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII •cveotAi v0003aa�ovos/wo/o /o• <br />