HALL AQUATIC LIFE SUPPORT DESIGN CONSULTANTS, LLC 1-2017

Home Browse Search

<►co�rta® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 1012712017 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(les) 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 entlorsement s . PRODUCER CONTACT CS&SIBIZINSURE LLC NAME: PHONE FAX (AIC, No, Ext): (AIC, No): PO BOX 958489 LAKE MARY, FL 32746-8989 E-MAIL Phone - 415-704.1408 ADDRESS: INSURER 5 AFFORDING COVERAGE NAIC p Fax - 877.763.5122 INSURERA: National Fire Insurance Company of Hartford 20478 INSURED HALL AQUATIC DESIGN LLC INSURERS: 347 GRANT ST SE INSURER C INSURER D: ATLANTA, GA 30312 INSURER E: Valley Forge Coman 20508 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 CONTRACTOR OTHER DOCUMENT NTH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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, SR LTR TYPEOFINSURANCE ADDL INSD SUBR___POLICY WVD POLICYNUMSER EFF MMID11 POLICY EXP MMIDDiYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED $ 360,000 PREMISES (Ea occurrence) MED EXP (Any one person) 10,000 A Y N 6011593339 07/1812017 07118/2018 PERSONAL &ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, PRO- POLICY �JECT GENERAL AGGREGATE 4,000,000 PROOUCTS-COMPIOPAGG $ 4,000,000 XLED OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N N 6011593339 07/18/2017 07118/2018 BODILY INJURY (Per accident) PROPERTY DAMAGE (Peraccident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED I RETENTION$ $ WORKERS COMPENSATIONPER X Ori AND EMPLOYERS' LIABILITY STATUTE ER E.L. EACH ACCIDENT 1'660'006 E OFFICERIMEMBEER EXC UDED?ECUTIVE YIN (Mandatory In NH) If yes, describe under N/A N 6021475975 0313112017. 0 313112 01 8 E.L. DISEASE - EA EMPLOYEE $ 1'0002000 E.L. DISEASE -POLICY LIMIT $ 1'000,600 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City of Santa Ana, its officers, employees, agents and representatives are named as additional insured�ards to Gen I Liability as provided in the blanket additional insured endorsement as it pertains to work being perforrtl,,q��'y the named Bred underwritten contract.\�N City will be mailed 30 days written notice of policy cancellation. CERTIFICATE HOLDER CANCELLATION The City of Santa Ana 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS. AU�T/JH�ORIZED RE%PRESENTATDIVE W17 -M- gL(rI..KCL(AWL r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD