Laserfiche WebLink
CERTIFICATE OF <br />LIABILITY INSURANCE <br />9/13/2017D/YYYv) <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, <br />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 />POLICY EFF <br />MM/DD/YYYY <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 />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 1E OCCUR <br />PRODUCER <br />EMPIRE WEST INS SERVICES INC <br />4125 Temescal St Ste C <br />Fair Oaks, CA 5628 <br />CONTACTJeff .Kortan <br />NAME: <br />PHONEgl6 967-1130 FAx888)204-4268 <br />/C No :� <br />A'C' <br />E-MAIL <br />ADDRESS, Oe emplrewest.net <br />EACH OCCURRENCE $ 10 000,000 <br />OF04110 <br />MED EXP (Anyoneperson) $ 5,000 <br />INSURERS AFFORDING COVERAGE NAIC# <br />INSURERA: Century -National Ins. Co. 26905 <br />INSURED National Demolition Contractors <br />INSURERB: Landmark American Ins. Co. 10851 <br />1536 W. 25th Street, #248 <br />INSURERC:Everest Indemnity Ins. Co. 33138 <br />INSURER D: <br />San Pedro, CA. 90732 <br />(310) 732-1991 <br />EF4ML05833171 <br />INSURER <br />(310)420-2766 JCell <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY ® JE� a LOC <br />INSURER <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 />ILTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLIC NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MMIDD/YYYY <br />LIMITS <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 1E OCCUR <br />EACH OCCURRENCE $ 10 000,000 <br />DAMAGE 10 HEN I h: <br />P t, IS a occurrence $ 100 000 <br />MED EXP (Anyoneperson) $ 5,000 <br />X Pollution Liability <br />X Contractual Liability <br />PERSONAL &ADV INJURY $10 000 000 <br />C <br />EF4ML05833171 <br />3/26/2017 <br />10/1/2018 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY ® JE� a LOC <br />GENERAL AGGREGATE $10,000,000 <br />PRODUCTS - COMP/OPAGG $10,000,000 <br />JCGL Deductible $ 5,000 <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident $ 1,000,0 <br />BODILY INJURY (Per person) $ <br />A <br />X ANYAUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />X HIRED AUTOS X NON -OWNED <br />AUTOS <br />BAP0183212 <br />9/17/2016 <br />9/17/2017 <br />BODILY INJURY (Per accident) $ <br />PROPERTY DAMAGE $ <br />(Par ccide <br />Camp/Call Ded. $$500-$1,000 <br />X <br />J <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />LHA242199 <br />3/26/2017 <br />10/1/2018 <br />EACH OCCURRENCE $ 5,000,000 <br />AGGREGATE $ r r <br />DED I I RETENTION <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY Y/NyS�T�Py'(LTE <br />I PER OTH- <br />ER <br />E.L. EACH ACCIDENT $ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />N/A <br />E.L. DISEASE - EA EMPLOYEE $ <br />(Mandatory in NH) <br />Ifyes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />Professional Liability <br />C <br />(Claims Made Form) <br />EF4ML05833171 <br />3/26/2017 <br />10/1/2018 <br />(Limits included in the above) <br />Retro Date: 3/26/2012 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD101, Additional Remarks Schedule, maybe attached if more space is required) <br />Certificate Holder: City of Santa Ana, its officers, employees, agents, volunteers and <br />representatives, are named as Additional Insured as respects all insureds operations <br />per written contract. <br />RE: Agreement entered on February 21, 2017. <br />REVIEWED BY: �'" EUNICE FIEREDIA (PG I OF711 <br />City of Santa Ana <br />20 Civic Center Plaza <br />Ross Amex (M--36) <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2013 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2013/04) The ACORD name and logo are registered marks of ACORD <br />