2010 OFFICE SERVICES INC - Laserfiche WebLink

Home

20100 -1 OP ID: TM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 11/06/15 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(ies) must 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 endorsement(s). PRODUCER 626- 796 -1313 CONTACT NAME: Longo & Associates A.J. L License #0524739 626- 795 -1313 253 N. Lake Avenue Pasadena, CA 91101 PHONE Ext ; FAX No): E -MAIL ADDRESS: Blake Longo INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Ohio Security Insurance Co. X COMMERCIAL GENERAL LIABILITY X INSURED 2010 Office Services, Inc. INSURER B: West American Ins. Co. DAMAGE TO RENTED PREMISES Ea occurrence 2227 N Merced Avenue South El Monte, CA 91733 INSURER C: American Fire & Casualty 24066 INSURER D: Security National Insurance Co 19879 INSURER E: MED EXP (Any one person) $ 153000 INSURER F: $ 11000,000 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL IN SR SUBR WVD POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DD /YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 A X COMMERCIAL GENERAL LIABILITY X BKS1656219801 08/01/15 08/01/16 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 CLAIMS -MADE FxIOCCUR MED EXP (Any one person) $ 153000 PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 21000,000 4PPROVEI; GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 21000,000 F X POLICY PE LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1000000 $ > > BODILY INJURY (Per person) $ B X ANY AUTO X BAW1656219801 08/01/15 08/01/16 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 31000,000 X AGGREGATE $ 330003000 C EXCESS LIAB CLAIMS -MADE ESA1656219801 08/01/15 08/01/16 DED X RETENTION $ NONE $ D WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE Y / " OFFICER /MEMBER EXCLUDED? F—i (Mandatory in NH) N/A X SWC1082844 08/01/15 08/01/16 X WC STATU- O TORY LIMITS ER E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 11000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 130003000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Riverside named additional insured for auto and general liability per forms CG 8810. Waiver of Subrogation applies in regards to workers compensation per form WC 040306 attached. CERTIFICATE HOLDER CANCELLATION © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Riverside 3900 Main Street AUTHORIZED REPRESENTATIVE Riverside, CA 92522 © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD