Laserfiche WebLink
AC"Rv® CERTIFICATE OF LIABILITY INSURANCE <br />DATEI"M " <br />03/27/2018 <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 oertNlcate holder Is an ADDITIONAL INSURED, the pollcy(les) 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 endolsement(s). <br />PRODUCER <br />Appling Insurance Services <br />10846 BLOOMFIELD STREET N-2018-058 <br />LOS ALAMITOS CA 90720 <br />CONTACT NAME; Shell) Appling <br />PNHCO Ho E (662)594-8893 ,yc Na; (582)431-3665 <br />AOIXiE55: Sheili@applinginsurance.net <br />VSURERUH AFFORDING COVERAGE <br />NAIC N <br />INSURERA: MESA UNDERWRITERS SPECIALY INS. CO. <br />3683E <br />INSURED <br />SANDEE GEE <br />DBA: FULL SPECTRUM EDUCATIONAL SERVICES <br />PO BOX 595 <br />Dana Point CA 92629 <br />INSURER B: <br />INSURERC: <br />_ <br />INSURERD: <br />_ <br />INSURER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: CL1811200804 REVISION NUMBER: <br />THIS IS TO CERTIFY THATTHE 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 />LTR <br />TYPE OFINSURANCE <br />N <br />POLICY HUMBER <br />MrWDDmm <br />MMSAlYYYY <br />uMSTS <br />x <br />COMMERCIALGENERALLIABILI Y . <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE Fx7 OCCUR <br />PREMISE6 a omurenre <br />$ 100,00D <br />`f( <br />MED EXP(Any one pe,Ton) <br />$ 5,000 <br />CONTRACTUAL LIABILITY <br />x <br />PRIMARY/NON-CONTRIBUTORY <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />MP0004008012105 <br />02/10/2018 <br />001012019 <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />POLICY jECT LOC <br />PRODUCTS -Coup, ADD <br />$ 2,000.000 <br />S <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea amde,d <br />$ <br />BODILYINJURY(Rarpasonl <br />$u <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOSONLY AUTOS <br />BODILY INJURY (Per acdaerd) <br />S <br />PROPERTY DAMAGE <br />Pereo.Idenl <br />S <br />HIRED NON OVK$NED <br />AUTDSONLY AUTOS ONLY <br />S <br />UMBRELLA Line <br />OCCUR <br />EACHOCCURRENCE <br />S <br />AGGREGATE <br />$ <br />EXCESS DAB <br />CLAIM"ADE <br />DEB <br />I I RETEWICNS <br />$ <br />WORMERSiCOMPENSAl10N <br />LIA <br />AND EMPLOYERS' LIABILITY YIN <br />E <br />STATUTE ER <br />ANY PROPRIETORIPARTNERIEXECUTIVE El <br />OFFICERNEMRER FXCWPEOP <br />EL EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />WmUtwy In NNI <br />If yes, deevibe under <br />DESCRIPnON OF OPERATIONS Mbw <br />EL DISEASE -POLICY LIMIT <br />$ <br />DESCRIPmON OF OPERAPONS I LOCP.TIONS /VEHICLES IAGORD 101, AOtlRlanal ROmerka Sabaaub, may M apaaMd B more ageA la required) <br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVE ARE NAMED AS ADDTIONAL INSURED FOR (ABILITY, ENDORSEMENT <br />° <br />ATTACHED <br />��� <br />'SPECIALTY PRESENTATIONS .\Ca <br />30 DAY NOTICE OF CANCELLATION, 10 Day Notice of Cancellation for non-payment of premium <br />CERTIFICATE HOLDER CANCELLATION , is <br />SHOULD ANY OF THE ABOVE <br />DEB BOO\ E CANCELLED BEFORE <br />I8. <br />THE EXPIRATION DATE THER <br />OTICE DELIVERED IN <br />CITY OF SANTA ANA <br />ACCORDANCE VNITH THE <br />YPROVISI <br />PUBLIC LIBRARY <br />AUTHOR REPRESENTATIVE <br />26 CIVIC CENTER PLAZA <br />SANTA ANA <br />CA 92701 <br />01998-2016 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2018103) The ACORD name and logo are registered marks of ACORD <br />