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A4CC)R°® CERTIFICATE OF LIABILITY INSURANCE 0°ATE8/05/22D01"`MM" <br />13 <br /> <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. <br />CERTIFICATE <br />INSURANC REPR SENTATIVE OR PRODUCER, AND THE CEROT F1d14°fE?NSnTIIT'UAJOT?2ACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />R <br />``Jj <br />must be endorsed. If SUBROGATION IS WAIVED, subject to <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, <br />the policy(ies) <br />the terms and conditions of the policy, certain policiasIItray? re'guirekati ? <br />.A(Ntq A statement on this certificate does not confer rights to the <br />31.A <br />1 <br />1 <br />4,,r ff t {{ <br />certificate holder in lieu of such endorsement(s). <br /> <br />PRODUCER 1-800-95 t? <br />or <br />Y 1t <br />Arthur J. Gallagher & Co. <br />Arthur J. Gallagher & Co. Insurance Brokers PHONE )FAX <br />of California <br />Inc, (AIC N% E t (949) 349-9800 (qlc NoP (949) 349-9967 <br />, <br />18201 Von Kerman Ave, Suite 200 E-MAIL <br />ADDRESS: <br />Irvine <br />CA 92612 INSURER(S) AFFORDING COVERAGE NAICk __ <br />, <br />Jerry Niewiadomaki INSURER A: INSURANCE CO OF THE WEST 27847 <br />INSURED <br />"4J? l <br />®^' <br />INSURER B: <br />/ <br />MetroPro Towing, Inc. p t <br /> INSURERG: <br /> <br />2550 South Garnsey Street __ <br />INSURER D: <br />7 INSURER E: <br />Santa Ana, CA 9270 <br /> INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 35085389 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 />R TYPE OF INSURANCE AOOL <br />INSR SUBR <br />VIVID POLICY NUMBER MMIDDNYYY MMIDDYYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> <br />DAMAGE TO RENTED _ <br />- <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ <br /> --- <br /> CLAIMS-MADE OCCUR MED EXP(Any one person) $ <br /> PERSONAL &ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'LAGGREGATE LIMIT APPLIES PER. ?? }?/? TT;; C <br />As <br />7 ?,+ <br />FOP PRODUCTS - COMPIOP AGG $ <br /> <br />PRO- <br />k: D <br />[91 PI11/? . <br />$ <br /> POLICY <br />LOG • <br /> AUTOMOBILE LIABILITY <br />dawTA <br /> <br />• <br />COMBINED SINGLE LIMIT <br />E Id tJ_ _ <br /> ' 1 BODILY INJURY (Per <br />ers <br />n $ <br /> _i ANYAU <br />r0 .?. <br />T p <br />o <br />' <br /> ALL OWNED I SCHEDULED - iO3811 <br />?? ? nl <br /> -AUTOS !AUTOS ' <br />I BODILY INJURY (Per accident), $ <br /> WNED <br />A Syr ??.4 <br />eS <br />E <br />t$ <br />it <br />t' <br />` p <br />rn(F PROPERTY DAMAGE -- <br />$ <br /> :HIREDAUT06 ? <br />UTOS ? <br />" <br />•?y ' <br />lr <br />148 <br />l. <br />A '? (Per eocidenl <br /> <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br />A WORKERS COMPENSATION <br />ANDEMPLOYERS' LIABILITY X WSD502374600 04/01/1 04/01/14 X WC STATU- IOTFI- <br /> <br />I - -- - <br /> ANYPROPRIETORIPARTNERIEXECUTIVE? E.L. EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? NIA - -""'-'-- --" <br /> (Mandatory in NH) EA <br />E. pISEASE -A E MPLOYEr- $ 1,000,000 <br /> If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />1 <br />1 E.L. DISEASE - POLICY LIMIT _ <br />$ 1, 000, 000 <br /> I i <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) <br />Waiver of subrogation applies to the certificate holder on the workers compensation policy, per the attached form <br />WC990634800. <br />Re: Work performed by the named insured as required per written contract with respects to City of Santa Ana <br />Certificate holder continued: City of Santa Ana, its officers, officials, employees, agents, and volunteers <br />CERTIFICATE HOLDER CANCELLATION <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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br />Clerk of the Council <br />20 Civic Center Plaza (M-30) <br />AUTHORIZED REPRESENTATIVE <br />P.O. H 1988 <br />Santa Ana, CA 9 2702-198 8 <br />USA <br />ACORD 25 (2010105) <br />Tamiel23 <br />35085389 <br />© 1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD