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<br />BELLB-h OP ID: SO
<br />chKI IFICATE OF LIABILITY INSURANCE DATE(MMIODNYVY)
<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,
<br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />• BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN
<br />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
<br />an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsements .
<br />PRODUCER Phone: 951-676.3365
<br />United Agencies, Inc.(M)
<br />wAMTA T Stacy Ortiz
<br />PHON
<br />Arc NEa .951-676.3365 ac wa: 951.676-3020
<br />CA License#0252636 Fax: 951-676.3020
<br />Ste. 110
<br />Yneula,
<br />Temecula, CA
<br />Temecula, A 9
<br />ADDRESS; sortiZ uniteda encles.com
<br />Ryan E. Hollanderder
<br />INSURERS AFFORDING COVERAGE
<br />NAICN
<br />INSURED Bell Bullding Maintenance Co.
<br />INSURER A: Preserver Insurance Company, 1
<br />15586
<br />Mrs. Yang Ceda
<br />INSURER B: United Specialty Ins CO
<br />12537
<br />INSURER C: Topa Insurance Company
<br />p Y
<br />18031
<br />Sher Sepulveda Blvd.,#160
<br />Blvd,,
<br />Sherman Oaks, CA 91403
<br />INSURER D: --
<br />INSURER E
<br />COVERAGES rcor,n,rnr�un.....-,..-
<br />NSURER F;
<br />"—" "' "" """"""`• 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 />GENERAL LIABILITY
<br />POLICY NUMBER
<br />MMYDOmYY
<br />�YE
<br />MMID
<br />LIMITS
<br />B
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADE EX
<br />X
<br />X
<br />U$A4029224
<br />�y q� r
<br />,f''i,�,\J `+ b+
<br />L
<br />01/10/14
<br />py
<br />0 IT, �$
<br />_ _
<br />-
<br />D1110115
<br />�
<br />—
<br />N
<br />. EACH OCCURRENCE
<br />$ 1,000,00
<br />DA A T D
<br />PREMISES Eadccunenoe
<br />MED EXP(Any one parson)
<br />$ 100,00
<br />$ 5,0Q
<br />PERSONAL & ACV INJURY
<br />$ 11000100
<br />GENERAL AGGREGATE
<br />PRODUCTS - COMPIOP AGG
<br />$ 2,000,00
<br />GEN'L AGGREGATE LIMIT APPLIES PER',
<br />X POLICY ECT PRO LOC
<br />$ 11000100
<br />S
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRWAUTOS AUTO WNEDPROPERTY
<br />'
<br />.. L(jN ^-
<br />Ass$,,1.D[li
<br />(jy j�,ttGT
<br />I�f/
<br />2�
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />BODILY INJURY (Per person)
<br />S
<br />BODILY INJURY (Per eMldent)
<br />$
<br />DAMAGE
<br />Peraeoitlenl
<br />$
<br />C
<br />UMBRE
<br />EXCESS LALIAB
<br />EXCESS IJAe
<br />X OCCUR
<br />, CLAIMS -MADE
<br />XL6604652-01 :
<br />01/10114
<br />01110115
<br />EACH OCCURRENCE
<br />5 6.000100
<br />X
<br />AGGREGATE
<br />$ 5,000,00
<br />DED X RETENTION $
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNEPoEXECUrNE YIN
<br />OFFICERNEMBER EXCLUDED9
<br />(Mandatary in NH)
<br />IIA
<br />WCC QDD4999
<br />051Q2/13
<br />05/02114
<br />-
<br />X TORY LIMTIT OTH-
<br />E.L. EACH ACCIDENT -
<br />S
<br />$ 1,000,00
<br />L. DISEASE - EA EMPLOYEE
<br />$ 1,000,00
<br />Ryes, IIIunder
<br />OE SC RIPTION OF OPERATIONS belox
<br />E.L. DISEASE -POLICY LIMIT $ 11000,00
<br />DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Ahach ACORD IOl. Addifionel Remarks Schedule, If more space Is rsqulreal
<br />Certificate holder, its Officers, employees, agents, and representatives are
<br />named as Additional Insured in regards to the general liability where
<br />required by written contract, with primary and non-contributory wording in
<br />respects to the operations of the Name Insured.
<br />CERTIFICATE HOLDER
<br />City of Santa Ana
<br />Purchasing Department
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />CITYOFS
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />©1988.2010 ACORD CORPORATION. An r1nmA roaonsa
<br />41flj+
<br />r me r+wmr name and 1090 are registered marks of ACORD
<br />
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