Laserfiche WebLink
' <br />F~ <br /> <br />ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br />PRODUCER 06/25/2009 <br />Phone: (626) 854-9541 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />The Master Insurance Agency, InC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />18053 Valley Blvd., HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />City of Industry, CA 91744 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />License #: OB03663 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />wsuRERA: Travelers Insurance Com a <br /> <br />Softmaster, Inc. n <br />INSURER B: Oak River Insurance Com an <br /> 20640 OakCrest Drive IN <br /> SURER C: <br /> Diamond Bar, CA 91765 INSURE <br /> R 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 WIT <br /> H RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO <br /> ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR DD' <br /> POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> <br />A <br />GENERAL LIABILITY <br />X <br />6806259N475 <br />07/01/2009 <br />07/01/2010 LIMI <br />EACH OCCURRENCE TS <br />$ 2 QQQ 000 <br /> COMMERCIAL GENERAL LIABILITY <br />~ PREMISES Ea occurence $ 300 000 <br /> CLAIMS MADE <br />OCCUR MED EXP (Any one person) $ fJ QQQ <br /> <br /> PERSONAL & ADV INJURY $ 2 QQQ 000 <br /> <br /> <br />' GENERAL AGGREGATE $ 4 QQQ 000 <br /> GEN <br />LAGGREGATE LIMIT APPLIES PER: <br /> <br />PRO- <br />X PRODUCTS-COMP/OPAGG $ 4 QQQ 000 <br /> POLICY <br />LOC <br /> AUT OMOBILE LIAB <br /> ILITY <br /> ANY AUTO <br />COMBINED SINGLE LIMB <br />(Ea accident) <br />$ <br /> ALL OWNED AUTOS <br /> <br />SCHEDULED AUTOS BODILY INJURY <br />(Per person) <br />$ <br /> HIRED AUTOS <br /> <br />NON-OWNED AUTOS BODILY INJURY <br />(Per accident) $ <br /> <br /> pROVED A TO FO PROPERTY DAMAGE <br /> <br />(Per accident) $ <br /> GARAGE LIABILITY <br /> AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO - <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY AttoTne EACH OCCURRENCE $ <br />t~ssistant y Y <br />OCCUR ~ CLAIMS M <br /> ADE <br />AGGREGATE $ <br /> <br />$ <br />DEDUCTIBLE <br /> RETENTION $ <br /> a <br />B WORKERS COMPENSATION AND 22100000037-081 10/27/2008 10/27/2009 X WC STATU- OTH- <br />EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 OOO OOO <br />OFFICER/MEMBER EXCLUDED? <br /> If yes, tlescribe under E.L. DISEASE-EA EMPLOYE $ 1 OOQ 000 <br />SPE <br /> CIAL PROVISIONS below <br /> <br />E.L. DISEASE -POLICY LIMIT $ 1 000 000 <br />OTHER <br /> DESCRIPTION OF OPERATIONS !LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br /> Subject to Policy Terms, Conditions and Exclusions, insured for location at: <br /> 23 Peters Canyon Road, <br /> Irvine, CA 92606 <br /> *30 Days Notice should the policy cancel for non-payment <br /> CERTIFICATE HOLDER CANCELLATION <br /> <br /> <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> <br />Its Officers, Agents and Employees DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O* DAYS WRITTEN <br />NOTIC <br /> <br />r, <br />20 Civic Center Plaza E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> <br />~. <br />- P.O. BOX 1985-M12 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> <br />Santa Ana <br />CA 92702 REPRESENTATIVES. <br /> , AUTHORQED REPRESENTnTivF <br />ACORD 25 (2001/08) __ MEK <br />©ACORD CORPORATION 1988 <br />Printed by MEK on June 25, 2009 at 10:29AM <br />