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LE, CHOC 4 - 2015
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LE, CHOC 4 - 2015
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Last modified
3/25/2020 11:21:19 AM
Creation date
4/23/2015 3:41:18 PM
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Contracts
Company Name
LE, CHOC
Contract #
N-2015-057
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
7/1/2017
Insurance Exp Date
12/17/2017
Destruction Year
2022
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I CERTIFICATE OF LIABILITY INSURANCE <br />PRODUCER <br />M,Ip"ime lm.ulln- Agency, 111c <br />2701 200 <br />Mk,icin Viej., CA 92691 - <br />877,439 7459 <br />INSURED <br />ch., V L. <br />4 Fabriano <br />I ...... �, CA 9262G 2576 <br />COVERAGES <br />THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />G N —SL I R L�� <br />RNLORLEE: - INSURER (). <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN M.AY HAVE BEEN REDUCED BY PAID, CLAIMS. <br />.. ......... <br />INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION <br />LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YYYY) DATE (MMJDD/YYYYI LIMITS <br />A <br />x <br />GENERAL LIABILITY <br />PHIPK661902-005 <br />12117/2015 <br />1211712u1c, <br />[ALI I C(CURCNCF <br />S1,000,000 <br />) I to <br />-12K MjKiL- S - I cli 11 <br />1 <br />X_ 1,111AME RCIAL IS( NERAL I EA8Q I TY <br />CLAIMS MADE I'll `C(0)k <br />MEP EKE (Any one It <br />. ......... ---- <br />PRO, LSSIONAL LIABILITY <br />PER50NAL & ADV INJURY <br />GENERAL A(�L`R[E'ATC <br />GENT AGGREGATE I EMIT APPLIES PER: <br />"I <br />PRODUCTS-COMP/OP AGG <br />$1,000xvc <br />POLICY F I I F-1 Loc <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />ANYA111n <br />(EA ac,.Id,.n#) <br />At OWNLO At) I 0S <br />BODILY IWEIRY <br />S(ILDUECD AUT05 <br />HIRE I) AUT05 <br />BODILY INJURY <br />IPvtr au c ideal) <br />NON OWNED AUT05 <br />------------ <br />OAMA- <br />I Y G, <br />t <br />:;ROPER <br />Nm "ircIde"t) <br />GARAGE LIABILITY <br />. ......... . . ....... . . <br />ANYAUTC) <br />OTHER I I IAN FA ACC <br />AUTO ONLY: AGG <br />EXCESS / UMBRELLA LIABILITY <br />FACE I OCCURINCE <br />Oc"UM E:1 U.AIMMADE <br />AGGREGATF <br />THE UCTIRIF <br />RE FINTION <br />WORKERSLUMPE SAIIUNAND <br />WC1%`IATI- <br />EMPLOYERS' LIABILITY <br />LRMITS ER <br />ANYPROFIFTPR(PART IFI <br />.TORN <br />RIMER M13 R E <br />OFFI XCLUIN) D? in <br />EL EACH ACCIDENT <br />(Mandatory in NHI <br />F I DISEASE - EA AMP I OYIF <br />If <br />A <br />Sf4r��, OVI, NS hekm <br />- <br />F.L DISEASE � P01 ICY LlmLI <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS <br />It is understood and agreed that the fs,110,!ng entity i, addod as an additional insured but only with respect(s) to The oI of the nanieel 1--d except that liability reSUIting from the additional jnsijre,k snie <br />negligence. <br />CERTIFICATE HOLDER <br />City ofS,,.0 Ana, its officoi�s, o pby,—, ag—k, .p--wiv- & —I it—,, <br />)Q( , <br />Aw Plaza M 25 <br />S.M. Ana, (A WMI. <br />— — a <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE <br />THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL III DAYS WRITTEN NOTICE To THE <br />CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR <br />LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, <br />AUTHORIZED REPRESENTATIVE <br />eo <br />NEC- <br />ACORD 25 (2009/01) 0 1988-2009 ACORD CORPORATION. All <br />The ACORID name and logo are registered marks of ACORD <br />
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