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NATIDEM-01 JHOJNACKI <br />'4cc��2n CERTIFICATE OF LIABILITY INSURANCE <br />DATE 02/23/2017 ) <br />02/23/2017 <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 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 License # OD28764 CONTACT <br />NAME: <br />Orion Risk Management Insurance Services, Inc. PHONE , Ext): (949) 263-8850 FAX(AICNo):(g49) 263-8860 <br />1800 Quail Street, Suite 110 IA/EMAIL <br />Newport Beach, CA 92660 ADDRESS:, <br />INSURED <br />National Demolition Contractors INSURER C: <br />1536 W 25th St., Ste 248 INSURER D: <br />San Pedro, CA 90732 <br />INSURER F: <br />State ComiDensation Insurance <br />rrTil�ly 7_r ridadid rdr111d11111hGI:73c r r r <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 <br />BEEN REDUCED BY PAID CLAIMS. <br />IN <br />INSR ADDLISUBR, <br />POLICY EFF . POLI EXE " "LIMITS <br />R i TYPE OF INSURANCE N POLICY NUMBER <br />pY <br />COMMERCIAL GENERAL LIABILITY <br />EACH $ <br />EACH OCCURRENCE <br />- — --- ------ <br />CLAIMS MADE _,; OCCUR <br />_ <br />DAMAGE TO RENTED <br />..... <br />PREMISES(Ea.occurrence)_.. $ .__..,.__ .... ._.. <br />_. _..... <br />MED EXP (Any one person)_ <br />I <br />PERSONAL & ADV INJURY. $.. <br />GE E LIMIT PER: ! <br />N'L AGGREGAT, LIPECT I0 <br />GENERAL AGGREGATE $ <br />POLICY LOC <br />PRODUCTS -COMP/OP AGG $ _ <br />�I OTHER: <br />$ <br />AUTOMOBILE LIABILITY', <br />_..._.. <br />COMBINED SINGLE LIMIT <br />_(Ea _accident) __- ...._..._ <br />ANY AUTO <br />BODILY INJURY (Per person)OWNE$ <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) $ <br />NON�/U�/LEDI <br />PROPERTY <br />accidentDAMAGE <br />AUTOS ONLY . ONLY <br />$ <br />$ <br />UMBRELLA LIAB OCCUR <br />EACH OCCURRENCE $ <br />EXCESS LIAB CLAIMS-MADE.AGGREGATE <br />$ <br />DED RETENTION $ <br />$ <br />A WORKERS COMPENSATION <br />X <br />AND EMPLOYERS' LIABILITY YIN <br />;._STATUTE 1 ERH -- <br />ANY PROPRIETOR/PARTNER/EXECUTIVE '1156730316 <br />10/01/2016 10/01/2017 1,000,000 <br />OFFICERIMEMBER EXCLUDED. N A <br />E.L. EACH ACCIDENT $ <br />in NH) <br />1,000,000 <br />(Mandatory <br />E.L. DISEASE - EA EMPLOYEE $ <br />If yes, describe under i <br />" <br />1,000,006 <br />DESCRIPTION OF OPERATIONS below ' <br />E.L. DISEASE -POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES CORD 101 Additional Remarks Schedule may be attached if more ace is required) <br />( Y p 4 ) <br />f EVIEWED BY: EUNICE II IF_E�C1111, PG <br />City of Santa Ana <br />20 Civic Center Plaza <br />Ross Annex (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 />REPRESENTATIVE <br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />