Laserfiche WebLink
Cli—t&- 195QAAI <br />4fI r.CARrI(-1Cf"1R <br />ACORDT- CERTIFICATE OF LIABILITY <br />INSURANCE <br />DATE(MM/DD/YYYY) <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />1/19/2012 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />BB&T Insurance Services <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />of Orange County <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />680 Langsdorf Drive Suite 100 <br />GEN E LIABILITY <br />Fullerton, CA 92831 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />Cordoba Corporation <br />1401 N. BroadwayINSUNSRuRER <br />Los Angeles, CA 90012 <br />INSURER A: Sentinel Insurance Company, Ltd 11000 <br />INSURER B: Everest National Insurance Cc 10120 <br />c: Property & Casualty Ins Cc of H 34690 <br />IER D - <br />: <br />INSURER E: <br />COVER <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 <br />UD H <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM/DD/YYYY <br />POLICY EXPIDORATION <br />DATE MM /YYYY <br />LIMITS <br />A <br />GEN E LIABILITY <br />72SBACP3130 <br />01/20/2012 <br />01/20/2013 <br />EACH OCCURRENCE $1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />DAMAGE TREMISESO RENTED $1,000,000 <br />CLAIMS MADE F -RI OCCUR <br />MED EXP (—y— parson) $10,000 <br />PERSONAL & ADV INJURY $1,000,000 <br />GENERAL AGGREGATE $2 OOO 000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG s2,000,000 <br />X POLICY PRO- <br />JECT LOC <br />C <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />72UECUS9769 <br />01/20/2012 <br />01/20/2013 <br />COMB INED SINGLE LIMIT $,I ,000,000 <br />(Ea acc d—) <br />BODILY INJURY $ <br />(Per Person) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />X <br />BODILY INJURY $ <br />(Par accitlen[) <br />HIRED AUTOS <br />NON-OWNEDAUTOS <br />X <br />PROPERTY DAMAGE $ <br />(Per accid—) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: AGG 5 <br />A <br />EXCESS/UMBRELLA LIABILITY <br />72SBACP3130 <br />01/20/2012 <br />01/20/2013 <br />EACH OCCURRENCE $5000000 <br />X I OCCUR F] CLAIMS MADE <br />AGGREGATE $5,000,000 <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />X RETENTION $ 10000 <br />B <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />CA20011117121 <br />01/20/2012 <br />01/20/2013 <br />X TWO STATU- or H- <br />DRY <br />ANY PROPRIETOR/PARTNER/EXECUTIVEE <br />L EACH ACCIDENT 51,000,000 <br />gFFI ER/M E�gE�2 EXCLUDED? N <br />(Man story In NH) <br />E.L. DISEASE - EA EMPLOYEE $1,000,000 <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT S1,000,000 <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Per form SS0008 04/05 pages 11-13 of 24 attached, the following are named as Additional Insureds, as <br />respects General Liability, as required by written contract - <br />Additional Insureds: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its <br />officers, employees, agents and volunteers are named as additional insureds with regard to liability and <br />defense of suits arising from the operations and uses preformed by or on behalf of the named insured. <br />CERTIFICATE HOLDER CANCELLATION 10 Days for Non -Pa ment <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL in DAYS WRITTEN <br />20 Civic Center Plaza NOTICE TO THE CERTIFICATE HOLDER NAMED TO. THE LEFT, BUT FAILURE TO DO SO SHALL <br />Santa Ana, CA 92702-1988 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES - <br />AUTHORIZED REPRESENTATIVES J <br />ACORD 25 (2009/01) 1 of 2 #S8070243/M8064223 (D 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD LXMCN <br />