HomeMy WebLinkAboutCertificate of Liability Insurance Client# : 32271 AIRLINK
ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY)
04/22/99
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Armstrong/Robitaille Ins Svcs ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
680 Langsdorf Drive #100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 34009 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fullerton, CA 92834-9409 INSURERS AFFORDING COVERAGE
INSURED INSURER A:Reliance Insurance Co .
D & B SUPPLY, INC.
DBA: AIRLINK INTERNATIONAL INSURERS:
977 N. Enterprise St . INSURERD:
Orange, CA 92867 INSURERD:
INSURER E:
• COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYLDATE(MD WWI LIMITS
A GENERAL LIABILITY PB8572931 04/21/99 04/21/00 EACH OCCURRENCE $1, 000, 000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one f Ire) $ 50 , 000
CLAIMS MADE X OCCUR MED EXP(Any one person) $ 5 , 000
PERSONAL&ADV INJURY $1, 000 , 000
GENERAL AGGREGATE $2, 000 , 000
GENL AGGREGATELLIRMITAPPLIES PER: PRODUCTS-COMP/OP AGO $2, 000, 000
JEC
—1 POLICY 7 LOC
A AUTOMOBILE LIABILITY PB8572931 04/21/99 04/21/00 COMBINED SINGLE LIMIT
X ANY AUTO (Ea accident) $1, 000, 000
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS - _ (Per person) $
X HIRED AUTOS -
X NON-OWNED AUTOS (Per BODILY
Itleni)RY - $
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
_ AUTO ONLY: AGO $
A EXCESS LIABILITY QU8572931 04/21/99 04/21/00 EACH OCCURRENCE $5, 000 , 000
OCCUR CLAIMS MADE AGGREGATE $5 , 000, 000
DEDUCTIBLE '- -
X RETENTION $10000 $
EACH
ACCIDE
WORKERS COMPENSATION AND WC STATU- OTH-
EMPLOYERS'LIABILITY
E.L.E EACH A-- 4LTS N Ems____-",--_-
DENT $
E.L.DISEASE-EA EMPLOYEE $
E.L.DISEASE-POLICY L I MIT $
A OTHER PB8572931 04/21/99 04/21/00 $60, 000 limit,
Leased/Rented $2 , 500 Ded. , Spcl Form
Equipment 96100 Coin.
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY EN DORSEMENT/SPECIAL PROVISIONS
Cancellation clause is amended to include 10 day notice for non-payment .
Project : Job #114 Santa Ana Police Administration & Holding Facility.
Certificate Holder, Santa Ana Financing Authority, Their Officers, Agents
and Employees are named as Additional Insured as their interest may
appear.
CERTIFICATE HOLDER ADDII1ONALINSURED;INSURER LETTER CANCELLATION
SHOULD ANYOFTHE ABOVE DESORIBEDPOLICIES BE CANCELLED BEFORETHE EXPIRATION
City of Santa Ana DATE THEREOF,THE ISSUING INSURER WILLENDEAVORTOMAIL3.0 DAYSWRITTEN
20 Civic Center Plaza - M28 NOTICETOTHE CERTIFICATE HOLDERNAMEDTOTHE LEFT,BUTFAILURE TO DOSOSHALL
Santa Ana, CA 92701 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
•
REPRESENTATIVES.
AUTHOIIIZEDREPRESEN ATIVE
ACORD 25-S(7/97)1 of 2 #M74954 CJL S ACORD CORPORATION 1988
IMPORTANT
If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the Issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACDRD25-S(7/97)2 of 2 #M74954