ACORCP
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
6/1/2024 12/1/2023
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 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 endorsement(s).
PRODUCER LOCKTON COMPANIES
500 West Monroe, Suite 3400
CHICAGO IL 60661
(312) 669-6900
[email protected]
INSURED SDI Presence LLC
1424646 200 E. Randolph St
Ste 3550
Chicago IL 60601
CONTACT
NAME:
1 PHONE
A/CCMAIL No. Extl:
-
ADDRESS:
INSURER A :
INSURER B :
INSURER C :
I INSURER D :
1 INSURER E :
1 INSURER F :
FAX
(A/C. Nol:
INSURER(S) AFFORDING COVERAGE
The Charter Oak Fire Insurance Company
The Phoenix Insurance Company
Travelers Property Casualty Company of America
The Travelers Indemnity Company of Connecticut
NAIC #
25615
25623
25674
25682
COVERAGES CERTIFICATE NUMBER: 20101062 REVISION NUMBER: XXXXXXX
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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP WIYLIMITS
LTR INSD VD POLICY NUMBER (MM/DDYYYI (MM/DD/YYYYI
B X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO-
JECT
RO
PRO- X LOC
OTHER:
A AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
C
D
X UMBRELLA LIAB X OCCUR
EXCESS LIAB CLAIMS -MADE
DED X RETENT ON $ 10,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y/N
N
Y N H-630-0S724669-PHX-23 6/1/2023 6/1/2024
N N 810 -05724577 -23 -I3 -G 6/1/2023 6/1/2024
N N CUP -0S724762 -23-I3
N/A
N UB -0S724412 -23 -I3 -G
6/1/2023 6/1/2024
6/1/2023 6/1/2024
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident)
EACH OCCURRENCE
AGGREGATE
X STATUTE I ERH
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE PAGE 2
CERTIFICATE HOLDER
20101062
City of Placentia
401 E. Chapman Ste. 3550
Placentia CA 92870
CANCELLATION See Attachment
1,000,000
1,000,000
10,000
1,000,000
2,000,000
2,000,000
1,000,000
XXXXXXX
XXXXXXX
XXXVOCX
XXXXXXX
25,000,000
25,000,000
XXXXXXX
$ 1,000.000
$ 1,000.000
$ 1.000.000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESE TTATIV ••- ,•-- /•'' f
7' Y
© 1988-26 i ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
CONTINUATION DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS (Use only if more space is required) The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are included as additional insureds if required by written contract with respect to General Liability per the terms and conditions of the policy.
ACORD 25 (2016/03) Certificate Holder ID: 20101062
Attachment Code: D563661 Master ID: 1424646, Certificate ID: 20101062 City of Placentia
To whom it may concern:
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Please contact us via one of the methods below, referencing Certificate ID 20101062. • Email: Chicagoedelivery(a�lockton.com
• Phone: 866-297-8023
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Lockton Companies
Lockton Companies
500 W. Monroe Street, Suite 3400
Chicago, IL 60661