Laserfiche WebLink
,4�oRO® CERTIFICATE OF LIABILITY INSURANCE <br />°171201111 <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 policy(ies) 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 lieu of such endorsement(s). <br />PRODUCER <br />MARSH USA, INC. <br />445 SOUTH STREET <br />CONTACT <br />NAME: <br />FAX <br />(PAC, N A/C No)- <br />E -MAIL <br />ADDRESS: <br />MORRISTOWN, NJ 07960 -6454 <br />INSURERS AFFORDING COVERAGE <br />NAIC i <br />GLD11101 -02 <br />INSURER A: HDI- Gelling America Insurance Company <br />41343 <br />100129 -REPUB -10111 RE31C SACHS 1185 <br />INSURED <br />REPUBLIC INTELLIGENT TRANSPORTATION <br />SERVICES, INC. DBA REPUBLIC ITS <br />INSURER 0: Liberty MUIUN Fire Ins Co <br />23035 <br />INSURER C : Liberty Insurance Corporation <br />42404 <br />INSURER D: <br />371 BEL MARIN KEYS BLVD, #200 <br />NOVATO, CA 94949 -5699 <br />DAMAGE RNTED <br />PR MiSET EeEoccur occurrence) <br />$ 1'000,900 <br />MED EXP (Any one erson <br />INSURER E <br />PERSONAL &ADV INJURY <br />INSURER F; <br />COVERAGES CERTIFICATE NUMBER: NYG006215946-01 REVISION NUMBER: <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 />DL <br />S BR <br />POLICY NUMBER <br />- POLICY EFF <br />MM/DD/YY <br />POLICY EXP <br />MWO <br />LIMITS <br />A <br />GENERAL LIABILITY <br />GLD11101 -02 <br />10/01/2010 <br />1010112011 <br />EACH OCCURRENCE <br />$ 1,000.000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F_x ] OCCUR <br />DAMAGE RNTED <br />PR MiSET EeEoccur occurrence) <br />$ 1'000,900 <br />MED EXP (Any one erson <br />$ 100,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />- <br />GENERAL AGGREGATE <br />$ 7,500,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPIOP AGG <br />$ INCL. <br />X __1 POLICY PRO- LOC <br />$ <br />B <br />AUTOMOBILE <br />LIABILITY <br />AS2 -631- 004334 -210 <br />10101/2010 <br />10101/2011 <br />CO MBINED SIN) GLE LIMIT <br />2,000,000 <br />X <br />BODILY INJURY (Pe( person) <br />$ NIA <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />- <br />X <br />BODILY INJURY (Per accident) <br />$ WA <br />X <br />PROPERTY a cDAMAGE <br />e <br />$ WA <br />X NON-OWNED <br />HIRED AUTOS AUTOS <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE. <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DIED RETENTION $ <br />$ <br />O <br />WORKERS COMPENSATION <br />WA7- 63D-004334-010 (ADS) <br />10/01/2010 <br />10101/2011 <br />X WC STATU OTH <br />FR <br />C <br />C <br />AND EMPLOYERS' LIABILnY <br />ANY PROPRIETORIPARTNER/EXECUTIVE YIN <br />OFFICER/MEMBEREXCLUDED7 <br />(Mandatory in NH) <br />N/A <br />7- 631.004334.020(oR,wl) <br />EWT -S3N -004334 -040 OH <br />( ) <br />1010112010 <br />1010112010 <br />1010112011 <br />10101!2011 <br />EL. EACH ACCIDENT <br />1,000,000 <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />1500K LIMIT /$500KStEr <br />E-L. DISEASE - POLICY LIMIT <br />1,000,000 <br />$ <br />DESCRIPTION OF OPERATIONS LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />E: AGREEMENT FOR LED SL RETROFIT <br />CITY OF SANTA ANA IS HEREBY ADDITIONAL INSURED AS OBLIGATED UNDER CONTRACT. SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS <br />!MARY INSURANCE & OTHER INSURANCE MAINTAINED BY THE CERTIFICATE HOLDER SHALL BE EXCESS ONLY & NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER THIS POLICY. <br />IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON - PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP <br />0 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. <br />CITY OF SANTA ANA J Ali To FORM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />ATTN: KURT WIEMANN THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />200 CIVIC CENTER PLAZA -�� f , // ACCORDANCE WITH THE POLICY PROVISIONS. <br />SANTA ANA, CA 92702 <br />.LI AUTHORIZED REPRESENTATIVE <br />;IV A L i; r' r of Marsh USA Inc. <br />Manashi MukherjeeioLUr+oti„� <br />01988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />