Insurance - Coastal Traffic Systems Inc. - 2011-03-04 DATE(MWDDIYVYY)
•
ACORO CERTIFICATE OF LIABILITY INSURANCE 3/4/2011
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 pollcy(les)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). eoaTA
PRODUCER NAME:m Debbie Kilby _. - —
PMONE (559)222-7722 Ne)_(E$B)222-1124_
James G Parker Insurance Associates siIc No,Extl:
Ea DebbieRilbye jgparker Cam
License #0554959 ADORERS: — -
PRODUCER n0079068 - _
1753E Fir Ave CU TOMERIDP - —`
Erean° CA 93.720 - " INSURER(S)- INSURER(S)AFFORDING COVERAGE NAIL II
INSURED 4printw INSURER A:Zurich American Insurance /4-i- 16535. X
4pfltt'GD INSURERO:National Union Fire Insurance A _ XV
Coastal Traffic Systems Inc INBURERCI
1261 Logan Ave INSI/RER O: _
INSURER C. - -
Costa Mesa CA 92626 INSURER F.
COVERAGES CERTIFICATE NUMBER:11 12 GL tED>H add 1 inad 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES-LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR UDDLSUSR - vp UCYEFF POLICY EXP LIMITS
LTTR TYPE OF INSURANCE INN WYD POLICY NUMBER IN IDDIYYYI7 IMWVDNYYYI
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000_
DAMAGE TO RENTED 300,000
X_ lII COMMERCIAL GENERAL LIABILITY PREMISES Ms opWRanrA1 • $•
A I�CLPIM6-MADE IX OCCUR Gm<x77e59oa /17/2011f211712012 MED EXP(AnY one Deraon) E 10r400
$ X C D Included PERSONAL I ADV INJURY $ . 1,000,000
�J GENERAL AGGREGATE S 2,000,000
GENIAGGPEGATE LIMIT APPLIES PER PRODUCTS COMWCP AGO $ 2,000 000
' POLCY1]LIJECT E iLOO -
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _$
(Es acadent)
ANY AUTO BODILY INJURY(Per parson) S
ALL OWNED AUTOS BODILY INJURYIP acccOent) $
SCHEDULED AUTOS PROPERTY OA MACE id $
•
— I H RED AUTOS (Pe sc ea) -
JI NON-OWNED AUTOS 5
5
X UMBRELLA OAB X OCCUR EACH OCCURRENCE S 5,000,000
EXCESS LAB CLAIMSMADE AGGREGATE 5,000,000
• DEDUCTIBLE E
B RETENTION $ Ba011557935 Eh1h120fl /17/2012 S
WORKERS COMPENSATION I TORY TAM T$ Gm.
R
AND EMPLOYERS'LABIUTY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT S
I OFFICERIMEMBER ExGW DED> n'�NM
(Nand May In NH) EL.DISEASE EA EMPLOYEE S
'II yes. esenbe under EL DISEASE POLICY LIMIT S
A•--- DESCRIPTION OF OPERATIONS below
•
DESCRIPTION OF OPERATIONS I LOCATIONS(VEHICLES(AIMch ACORD 101,Additional sirens SCMdula,If may pm aIa tiRUln01
Certificate holder 1e neared as Additional Insured ae per fore U CL 1175 attached
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF NOTWE WILL BE DELIVERED IN
Costa Mesa Sanitary District ACCORDANCE WITH THE POLICY PROVISIONS.
628 W 19th Street
Costa Mesa CA 92627 AUTHORIZED REPRESENTATIVE ,G
S Parker III/DEILBI ��^e'� a 01%r-14—•...V.-
ACORD 25(2008109) C 1988-2009 ACORD CORPORATION. All rights reserved.
INS025(2009DSI The ACORD name and logo are registered marks of ACORD