Laserfiche WebLink
<br /> <br />DATE(MM/DD/YWY) <br />A%---' CERTIFICATE OF LIABILITY INSURANCE 04/2812011 <br />F <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(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 lieu of such endorsement(s). <br />PRODUCER R <br />ACT <br />Ri <br />A <br />k I <br />S <br />i E <br />on <br />erv <br />s <br />nsurance <br />ces West, Inc. FAX <br />PHONE <br /> <br />Los Angeles CA Office I (866) 283-7122 <br />(847) 953-5390 <br />(A/C. No. Ext): NC. No. <br />707 Wilshire Boulevard E-MAIL <br />Suite 2600 ADDRESS: <br />LOS Angeles CA 90017-0460 USA <br /> INSURER(S) AFFORDING COVERAGE NAIC • <br />INSURED INSURER A. Zurich American Ins CO 16535 <br />SCS Engineers INSURERS: steadfast Insurance company 26387 <br />3900 Kilroy Airport way <br />suite 100 <br />, <br />Long Beach CA 90806-6816 USA INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> INSURER F: <br />arvvcfwuca "Kiii-n pue NIJIM c: 0/uu4Zo-I`I.J4J' KEV151UN 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. Limits shown are as requested <br />LTR TYPE OF INSURANCE INSR WV POLICY NUMBER MMID MMIDD LIMITS <br />GENERAL LIABILITY GLO 11 EACH OCCURRENCE $2,000,000 <br />X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100,000 <br />CLAIMS-MADE X? OCCUR MED EXP (Any one Person) S10,000 <br />PERSONAL S ADV INJURY 51, 000 , 000 <br />GENERAL AGGREGATE 52,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG 52,000,000 <br />POLICY X PRO- LOC o <br />A <br />AUTOMOBILE LIABILITY BAP 80 44 40S 17 03/31/20110313112012 COMBINED SINGLE LIMIT 51,000,000 ? <br />IaLJOliv accldentl <br />.. <br />X ANY AUTO 1 ' } BODILY INJURY (Per Person) Z <br />ALLOWNEO SCHEDULED <br />X AUTOS I AUTOS BODILY INJURY (Per accident) <br />X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE tMO <br />AUTOS ; Per accident <br />UMBRELLA LIAR OCCUR W N0 <br />1 t; EACH OCCURRENCE V <br />SS LIAR CLAIMS-MADE 7 sI AGGREGATE <br />4DEo RETE NTION <br />A WORKERS COMPENSATION AND WC 699900 04/01/20n 04/01/2012 X WC sTATU- OTH- <br />A EMPLOYERS' LIABILITY Y/N wc283700000 04/01/201104/01/2012 TORY LIMITS ER <br />ANY PROPRIETOR / PARTNER I EXECUTIVE N E. L. EACH ACCIDENT S1,000,000 <br />OFFICER/MEMBER EXCLUDED? N/A <br />(Mandatory In NH) E.L. DISEASE-EA EMPLOYEE S1,000,000 <br />Use, eOunder <br />DESCRIPTIOIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMB <br />FO $1,000,000 <br />B Env Pro (EW) PEC948263300 03/31/2011 03/31/2012 Each Claim 51,000,000 <br />Prof/Poll Liab Aggregate $2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mots Space Is required) <br />Job No. 90000016.01 Task 0000, Job Description: Environmental Services. City of Santa Ana, its officers, employees, agents, <br />Volunteers and representatives are included as Additional Insured as required by written contract, but limited to the <br />operations of the insured under said contract per the applicable endorsement with respect to the General Liability and <br />Automobile Liability policies. General Liabi)ity policy evidenced herein is primary to other insurance available to an <br />additional insured, but only to the extent required by written Contract with the insured. See attached Endt U-GL-1175-8 CW <br />(3/2007) and CA 20 48 02 99. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />City of Santa Ana AUTHORIZED REPRESENTATIVE <br />Attn: Marylin Booth <br />20 Civic Center Plaza M-36 ? ?!slNte?? ?? <br />Santa Ana CA 92702 USA <br />@1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD