|
CERTIFICATE OF LIABILITY INSURANCE
<br />ATE (MMIDDNM
<br />D9/23/2015 )
<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(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 />Equity Risk Partners, Inc.
<br />License No. OD21146
<br />456 Montgomery St, Suite 1600
<br />San Francisco CA 94104
<br />NDMEADT Partners Service Group
<br />PHONE (415) 874-7168 FAX No. (415)874-7170
<br />noDalESS:Ps4@equityrisk.com
<br />INSURERS AFFORDING COVERAGE
<br />NAICIt
<br />INSURER A:Travelers Indemnity Cc of America
<br />25666
<br />INSURED
<br />Ventiv Technology Inc.
<br />3350 River'wood Parkway
<br />Suite 80
<br />Atlanta GA 30339
<br />INSURER B:Travelers Indemnity CO of CT
<br />25682
<br />INSURER C:Travelers Prop/Casualty Prop/Casualtyof Ame
<br />25674
<br />INSURER D:
<br />INSURER E:
<br />A
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER:CL159118563 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 />ADDL
<br />SUBIR
<br />POLICY NUMBER
<br />POLICY EFF
<br />IMMIDDIVYYY1
<br />POLICY EXP
<br />(MMIDDIYfYY1LIMITS
<br />Anthony Marcon/MARTM '
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,000
<br />A
<br />CLAIMS -MADE 1XI OCCUR
<br />RENTED 300,000
<br />PREMISES o currence $
<br />(Eit
<br />MED EXP (Any one person) $ 10,000
<br />6309E758405
<br />8/29/2015
<br />8/29/2016
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $ 2,000,000
<br />X POLICY ❑PRO-
<br />JECT D LOC
<br />PRODUCTS - COMP/OP AGO $ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />Ea accident
<br />BODILY INJURY (Per person) $
<br />E
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />RA 9E76 6098
<br />8/29/2015
<br />8/29/2016
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE
<br />Per accident $
<br />X
<br />NON -OWNED
<br />HIRED AUTOS X AUTOS
<br />Deductible: Com /Colllsion IS 100/500
<br />XUMBRELLA
<br />LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 10,000,000
<br />AGGREGATE $ 10,000,000
<br />C
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I X I RETENTION 10,000
<br />$
<br />HBNCUP9E758405TIL15
<br />8/29/2015
<br />8/29/2016
<br />WORKERS COMPENSATIONPER
<br />AND EMPLOYERS' LIABILITY YIN
<br />X OTH-
<br />STATUTE ER
<br />ANY PROPRIETORIEXCLUDRIEXECUTIVE
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />C
<br />(MandatoryOFFICEWMEMBER EXCLUDED? ❑
<br />NH)
<br />(Mss,
<br />NIA
<br />HOUHOE26087615
<br />8/29/2015
<br />8/29/2016
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br />describe
<br />0 yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />C
<br />Errors 6 Omissions
<br />Various
<br />8/29/2015
<br />8/29/2016
<br />Aggregate Limit: $25,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Re: Ventiv Technology Inc., 3350 Riverwood Parkway, Suite 80, Floor 5th, Atlanta, CA 30339
<br />CERTIFICATE HOLDER CANCELLATION
<br />© 1988-2014 ACORD CORPORATIONAll rjew4wved��,
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Ivi, / t �('S'
<br />INS02512m4n11 N
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City Of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza, M-30
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />Anthony Marcon/MARTM '
<br />© 1988-2014 ACORD CORPORATIONAll rjew4wved��,
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Ivi, / t �('S'
<br />INS02512m4n11 N
<br />
|