NATIONAL DEMOLITION CONTRACTORS - 2017

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AC"ORE? CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) �,.... '' 09/26/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Andrew Gelua NAME: atehanD Wayne Fehr, State Farm Insurance PHONE 909-861-0493 FAX 909-274-7774 3220 S Brea Canyon Road Ste C _t9LG, L4 — - -- --------------------talc N ---------- E-MAIL andrewelua.khzk@statefarm.com statefarm.com (,w.. ADDRESS: g INSURER(S) AFFORDING COVERAGE NAIC # ,d Diamond Bar, CA 91765 INSURERA: State Farm Mublal Automobile Insurance Company 25178 -------- - - - -----. -------------- - INSURED -------------------------------��--- �-....'-- INSURER B: National Demolition Contractors, Inc. _ INSURER -C: 1536 W. 25th Street, # 248 __--------T __1536 INSURER D San Pedro, CA 90732 INSURER E: (310)732-1991, (310)420-2766 JCell -----=------------ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR (ADDL SUBR�—___-.._....__...-( POLICY EFF POLICY EXP —-- ---- .-._-__.___._-...__ LTR TYPE OF INSURANCE f POLICY NUMBER MM/DD/YYYY MM/DD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE �_ OCCUR DAMAGE TO RENTED REMISES (Ea occurrence —� - — $ — — _ MED EXP An one erson PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I_ $ (---- ---- ----- — POLICY IJPRO- L ...J PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY Y Y 595-1702-75 09/16/2017 03/16/2018 COMBINED SINGLE LIMIT dINJU $ 1,000,000 ANY AUTO BODILY YR (Per person) $ OWNED SCHEDULED AUTOS ONLY ! AUTOS BODILY INJURY (Per accident)1 ---------- $ _— — HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY r accident) _. _ __(Per _ - I UMBRELLALIAB CUR OIAIMS-MADE EACH AGGREGATEORRENCE_— 111 $_----- EXCESS LIAB --_ — —i 'DED RETENTION $ _ — $ WORKERS COMPENSATION ORH AND EMPLOYERS' LIABILITY Y / N STATTH- UTE F--------- -` ---.._ ---- E.L. EACH ACCIDENT -------------- ----------------- $ ANY PROPRIETOR/PARTNERlEXECUTIVE ❑ NIA OFFICER/MEMBER EXCLUDED? ;------------------------------------ (Mandatory in NH)�.E.L_DISEASE -EA EMPLOYEE $— If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT - j $ I I I I i DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, its officers, employees, agents, volunteers, and representatives, are named as additional insured. EREVIEWED BY: _ EUNICE HEREDIA (PG OF )] City of Santa Ana 20 Civic Center Plaza Ross Amex (M--36) Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 1001486 132849.12 03-16-2016