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AA�!RV CERTIFICATE OF LIABILITY INSURANCE <br />DATE3120/2015 Y) <br />20/2015 <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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement an this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s). <br />PRODUCER <br />KP Insurance Services <br />1331 Bth Street Ste 12 <br />Glendale, Ca 91201 <br />CONTACT <br />NAME- Ken Palk <br />PHONE M E,,, 213)8203943 <br />E-MADDRESS• ken.palk@yahoo.com <br />INSURERBAFFORDING COVERAGE <br />NAIC# <br />INSURER A: Infinity Insurance Company <br />INSURED <br />Bell Building Maintenance <br />5170 Sepulveda Blvd, <br />Sherman Oaks, Ca 91403 <br />INSURER B: <br />INSURER c: <br />INSURER D: <br />INSURfiP 6: <br />NSURER P <br />_ —_ <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />OF INSURANCE <br />AQV�TYPE <br />UUOK <br />POLICYNUMSER <br />PMIDoYYfEFF <br />M1yIDDryEXP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS.MADE OCCUR <br />EACHOCCURRENCE <br />$ <br />q AGE ORE E <br />$ <br />MEDEXP Airyore ereoh <br />_ <br />$ <br />GEN'L <br />PERSONAL &ADV INJURY <br />$ <br />AGGREGATE LIMIT APPLIES PER: <br />OP OLIDY�JEO LOG <br />OTHER'. <br />GENERAL AGGREGATEP"O <br />$ <br />PRODUCTS- COMPIOP AGO <br />$ <br />$ <br />A <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OSNEO X AUTCSULED <br />HIRED AUT08 AUTOS NON-OWNED <br />Y <br />5046129802 <br />04/1412014 <br />411412015 <br />EOM�BII,NUEDI SINGLE IT <br />$ 1,000,000 <br />SON LY INJURY (Per person) <br />Is <br />BODILY INJURY (Per accident) <br />$ <br />PeO.Cumat DAMAGE <br />$ <br />UMBRELLA UABLJ <br />EXCESS LIAB <br />OCCUR <br />CLAIMS-MAOE <br />Reviewed <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANYPROPRIETORIPARTNERIEXECUTIVE YIN <br />OFFICER/MEMEER EXCLUDED? <br />(mandate In NH) <br />OEBCRIPTION OF OPERATIONS beloW <br />NIA <br />j (. <br />"i <br />STA U E H <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />Silvia Cuevas <br />EL DISEASE, POLICY LIMIT <br />$ <br />PRCSA/Ad <br />in. <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It mare space is required) <br />Insured is a janitorial service contractor. <br />The certificate holder Is named as an additional insured of the policy. <br />City of Santa Ana <br />Purchasing Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, Ca 92702 <br />AUTHORIZED REPRESENTATIVE <br />©1989.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />