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Ac R CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMdDD YYYY)
<br />0211512017
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER CONTACT JOey WQlllarns
<br />NAME:
<br />Slade& Collins Insurance Agency PHONE _ FAX _
<br />3320 Clays Mill Road (A/C. Nq,, Ext)t (A/C, No):
<br />E-MAIL Joe�@SladeandCollins.com
<br />Suite 109-2016®2 ADDRESS.y@
<br />INSURED
<br />LeAngton, KY40503
<br />1648McGrathianaPkwySte360
<br />INSURER C
<br />LPAngton, KY405111a3
<br />INSURER D:
<br />INSURE S AFFORDING COVERAGE NAIC p
<br />Liberty Mutual Insurance 24082
<br />Pnix Insurance Company 2515323
<br />COVERAGES CERTIFICATE NUMBER;
<br />REVISION NUMBER«
<br />IS IS TO CERTIFY TRAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED NOTWITHSTANDING ANY REQUIREMENT, TEFW OR CONDITION ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH
<br />THIS
<br />CERTIFICATE Y BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL
<br />,
<br />EXCLUSIONS AND CONDITIONS SUCHPOLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR ......... ......-. "ADDL SUBR-' ....... _.
<br />POLICY EFF POLICY EXP
<br />I
<br />LTR TYPE OF INSURANCE : I PI`.1D POLICY NUMBER lIDDIYYYY} IdDDdYYYY,V,
<br />l
<br />LIMITS
<br />A COMMERCIAL GENERAL LIABILITY Y ',. BKS57763682 02/04/201 /' 02/04/2018
<br />'.. II.::1,110CCI1RRENCE
<br />$
<br />1,000,000
<br />CL AMS4" 9E ` OCC0.A6d
<br />-
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<br />1,0w'( iO
<br />_
<br />..... ...
<br />....
<br />K4-.iD Fx1P tAoy (Fuw pers'A; ) ".ICI
<br />n(
<br />....
<br />15e 000
<br />PE R ST)ek 9 AIN PWR`d
<br />III
<br />G :InQ AGGREGATE. Q QAT APr ^ 'S PER
<br />GENERAL A(W3RECA1 E.
<br />$
<br />2,000,000
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<br />........ .ua=<;r' _
<br />0"d:E@:)II.ALUC.".TS C('DNV,-0U'd CbO"AR',fx
<br />2,0QYQ7,000
<br />0
<br />OTHER
<br />$
<br />... ........
<br />AUTOMOBILE LIABILITY
<br />(ESINf.;LE LI
<br />CO ua(uc➢asdw nl)
<br />.........
<br />......... .........
<br />ANY AUTO '....,
<br />'.. 0.:90Q:(LYNARY (Per person)
<br />$
<br />O _D SCI-E.D UILE11
<br />BODILY UN,W, RY (P'atr arct:wiieaM)
<br />S
<br />......
<br />AUTOS ONLY AUTOS
<br />IfRED NON-C}V%E`.D
<br />FIROFIERTYbArVAwiV-",,,,,,,,,,,,,,,,,,,,,,,
<br />$
<br />AI90S OI'°.t..Y AUTOS OrLY
<br />I o*r I.ua;Ava�r} _.
<br />.........
<br />.........
<br />UMBRELLA LIAB CXICI.R
<br />..,,_..
<br />EACH OCCUJUdI•%Q',Q'A E
<br />. . . . . . . . . . . . .
<br />.$ ..................
<br />.
<br />EXCESS LIAB CLAW '.7E'.
<br />AC';t: Q CaA'T'E
<br />Dell oT n1LLWT.44' I.-T. _ - ��...
<br />— — ... .�..$
<br />...... -
<br />.........
<br />WORKERS COMPENSATION
<br />E3 I lV U E 4022T " 16 12/0412.016 12/ 201 Y
<br />= IN ER ra t La.
<br />AND EMPLOYERS LIABILITY YIN
<br />i ST/m.,n E... I:.. .....
<br />....
<br />..
<br />AWE IIRP6E
<br />UTAX-iI•Nq IX",N PUGWeII!II.
<br />EA. QA4INACCNIENT
<br />°'
<br />CYTh;T 6MVE MB X NIA
<br />....
<br />..'
<br />datary in NH) '..
<br />L: Q.. Q.1V„C 4%,�L` d(S _ TPw96'"L.ONT IE:
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<br />1 yes, ck;+: 'vbae urwJ e(
<br />........ ........
<br />500,000
<br />DESCRPTIOIN OF OPERARONS Wow
<br />c.Q.. DiSE...A.:'uQ::... UM.'1Q tcy L it
<br />$
<br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (ACORD 101, Additional Rernarks Schedule, may be attached It rnore space is required)
<br />.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Its Officers, EmpIoyees, Agents
<br />VOdunteur:.; & RepresentaltivLs
<br />20 Ci AC. Center Plaza
<br />Santa AI'la, CA 92701
<br />ACORD 25 (2016/03)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE MILL BE DELIVERED IN
<br />ACCORDANCE NTH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE (...` / ..
<br />@ 1988-2015 ACORD CORPORATION. All rights reserved,
<br />The ACORD name and logo are registered marks of ACORD
<br />
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