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Last modified
8/9/2017 4:49:38 PM
Creation date
8/9/2017 3:59:07 PM
Metadata
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Template:
Contracts
Company Name
SENSIS
Contract #
A-2016-154-01
Agency
Police
Council Approval Date
6/21/2016
Expiration Date
2/28/2018
Insurance Exp Date
3/1/2018
Destruction Year
0
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A� hP CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />s�13/20>� <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(les) 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 endorsements . <br />PRODUCER <br />CAONMTACTE: Carlos Alfaro <br />N <br />_ <br />PHONE (818)781-8112 INC N 1, (018)981-2460 <br />INSURENEX - VN Insurance Services <br />California Lic. OF23523 <br />E-MAIL CdY109.ea0inBllreneX.COdo <br />ADDRESS: <br />14402 Baynes Street, Suite 103 <br />_ <br />________1NSURERfSt AFFORDING COVERAGE NAICIf <br />Van NUye� CA 91401 <br />INSURERA:Sentinel_ Insurance Company Ltd 11000 <br />_ <br />INSURED <br />INSURERBAmGuard Insurance Company 92390 <br />INSURERCA-Xis apples Insurance Company 37273 <br />Sensis Inc, <br />DBA:Quijote Corporation <br />INSURER D: <br />BIB S. Broadway Suite 1100 <br />INSURER E: <br />Los Angeles CA 90014 <br />1 INSURER F: <br />COVERAGES CERTIFICATE NUMBER:CL1732101589 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 />INSR <br />R <br />SUER <br />TYPE OF INSURANCE ADDL POLICY NUMBER POLICY EFF <br />....P LIC E P <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLXMS.MADE O OCCUR <br />EACH OCCURRENCE 1,000,000 <br />_$ <br />DAMAGET RENTED 1,000,000 <br />PREMISES Ea ac- rr co $ <br />MEDEXP{Anyoneperson $ 10,000 <br />X S7SIIABG5955 5/26/2017 <br />5/26/2018 <br />PERSONAL &ADV INJURY $. <br />_ <br />..........................1,000,000 <br />GENERALAGGREGATE S 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY EJ JECT LOC <br />PRODUCTS COMPIOP AGG $2,000,000 <br />..... .................... <br />Nomowned $ 1,000,000 <br />OTHER <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE_IMI 1 $ 2,000,000 <br />Ea accident <br />'A <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS 578BABO5955 5/16/2017 <br />5/26/2018 <br />BODILY INJURY (Per person) $ <br />— -" <br />BODILY INJURY (Par accident) $ <br />HIRED ALTO$ NXNON-OWNEDPROPERTY <br />X HIRED AUTOS X AUTOSPeraccident <br />DAMAGE <br />$ <br />UMBRELLA UAB OCCUR <br />EACHOCCURRENCE $ <br />EXCESS LU B CLAIMS MADE <br />AGGREGATE 1$ <br />DED RETENTIONIs <br />WORRERS COMPENSATION <br />AND EMPLOYERS LIABILITY YIN <br />X PER 0TH• <br />STATUTE ER <br />E.L. EACH ACCIDENT $ 1,000 000 <br />B <br />ANY PROPRIETOMPARTNERfEXECUTIVE <br />OFFICER/MEMBER E%CLUDED? y NIA <br />(Mandatory in NIB shwC700298 3/1/2017 <br />3/1/2018 <br />E.L. DISEASE - EA EMPLOYE $ 1 000 000 <br />N, dostabs under <br />0DCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $ 1,000,000 <br />C <br />Professional Liability MCN000107111502 4/4/2017 <br />4/4/2018 <br />Each Claim 2,000,000 <br />A <br />Business Personal Propety 57SBABG5955 5/26/2017 <br />5/26/2018 <br />85,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />Santa Ana Police Department is added as an additional insured to the policy. Coverage is subject to the <br />terms and conditions of the insurance policy. <br />,0,4A�O /tf ✓po. <br />CERTIFICATE HOLDER CANCELLATION <br />EN <br />ACORD 25 (2014701) <br />INS025m iorl) <br />0 1988.2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Santa Ana Police Department <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />60 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />Carlos Alfay.'o/MF, <br />ACORD 25 (2014701) <br />INS025m iorl) <br />0 1988.2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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