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178584 Servando Varela dba Xv Solutions Certificate of Insurance (page 1 of 1)
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />82/17/2Q17 12:06:02 M
<br />DATE (MM/DD/YYYY)
<br />2/17/2017 „
<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 />PRODUCERCONTACT
<br />''... NAME:
<br />Techinswrance
<br />PHONE tea c N4 x }: $00.568-7020 IA✓c. Nod (877) 826-9067
<br />°° 1101 Central Expy. South, Suite 250
<br />:': Tech Insurance
<br />EMAIL
<br />_ADDRESS:
<br />Allen, TX 75010
<br />__..-__. ...
<br />INSURER(S) AFFORDING COVERAGEMAIC k
<br />INSURER A.: Sentinel Insurance Com an. . ....� 11000
<br />Limited
<br />_Py -... _ _ _ .
<br />..,..,,.....
<br />..INSURED
<br />INSURER B : Hartford Fire .Insurance QafDppny _... 19682
<br />..... .
<br />Servando Varela dba. Xv Solutions
<br />INSURER C :
<br />344 Orange Blossom
<br />_..___ . ..__................ _... _._ ................
<br />INSURER o
<br />Irvine, CA 9261$
<br />INSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUIMBER- RFVIglnN NHM'RFR°
<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 />_.
<br />(NSRTYPE
<br />LTR
<br />OF INSURANCE
<br />ApDC-'SUBR
<br />_...... ..-.w.
<br />POLICY EFF POLICY EXP
<br />POLICY NUMBER MM✓pp/YYYY MM1DDlYYYY
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE 2,000.000
<br />S
<br />CLAIMS -MADE P OCCUR
<br />..6Ad AA, E"rrT'RENTED ._ 1.000,000
<br />6�R' MISES Ea occurrence
<br />MED EXP (Arty one person) S 10,000
<br />PERSONAL 2,000.,000
<br />A(- &ADV INJURY $
<br />A
<br />Yes
<br />46SBMUN0237
<br />613012016
<br />6/30/2017
<br />GEN'L AGGREGATE. LIMIT APPLIES PER:
<br />I.. S 4,000,000 .1
<br />GENERAL AGGREGATE I
<br />POLICY 7 PRO- 7 LOC
<br />JECT
<br />PRODUCTS - COMP/OPAGG. S 4.000,9 00 _.._.,....
<br />OTHER:
<br />AUTOMOBILE LIAaBLITY
<br />SINGLE LIMIT
<br />COMBINED $
<br />Ea a"'dent
<br />BODILY INJURY (Per person) 5
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />_,..._...__..�__...,
<br />BODILY INJURY (Per accident) $
<br />NON-OWNiED
<br />PROPERTY DAMAGE
<br />HIRED AUTOS AUTOS
<br />Par accident
<br />S
<br />UMBRELLA LIAB
<br />HCLAIMS-MADE
<br />OCCUR
<br />EACH OCCURRENCE S
<br />EXCESS LIAB
<br />AGGREGATE S.
<br />DED RETENTION$
<br />$.
<br />WORKERS COMPENSATION
<br />''i OTH-
<br />ANY / N .D EMPLOYERS' LIABILITY
<br />SPER
<br />TATUTE ..., ER
<br />E.L. EACH ACCIDENT $ m
<br />ANY PROPRIETORIPARTNEPIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? ❑
<br />N/A
<br />E.L. DISEASE - EA EMPLOYE $
<br />(Mandatory in NH)
<br />If yes„ describe under
<br />DESCRIPTION OF OPERATIONS below
<br />F .. DISEASE -POLICY LIM..IIT
<br />B
<br />Professional Uabillty (Errors and Omissions)
<br />46TE0294403
<br />103/2017
<br />W312018
<br />$1,000,000 f 51,000,000
<br />DESCRIPTION Of OPERATIONS / LOCATIONS / VEHICLES ACORD 101,. Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana and Its Officers, agents, representatives, Volunteers, & employees are named as Additional Insured as their interests may appear in regards to
<br />general! liability. This insurance is primary and non-contributory to any other insurance provided as respects general liability coverage. Should any of the above
<br />described policies be cancelled before the expiration date, the issuing insurer will endeavor to mail 30 days Wratten notice (10 days notice if due to non-payment)
<br />to the certificate holder named below, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives..
<br />UCr1 Ii Ir iuA I C r1ULL7C1`1 1, ANJLr1=LLA. I JUN
<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 />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are regi'ster'ed marks of ACORD
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