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Last modified
10/23/2018 11:27:56 AM
Creation date
10/8/2018 2:36:06 PM
Metadata
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Template:
Contracts
Company Name
NINYO & MOORE
Contract #
A-2018-191
Agency
PUBLIC WORKS
Council Approval Date
8/21/2018
Expiration Date
8/20/2021
Insurance Exp Date
5/1/2019
Destruction Year
2026
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AC")?" CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />`" <br />10/4/2018 <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 certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s). <br />PRODUCER CONTACT <br />NAME: Doris A Chambers <br />Dealey, Renton & Associates PHONE FAX <br />AIC No): 510-452-2193 <br />P. O. Box 12675 A/C No Ext): 510-465-3090 (AIC, <br />Attn: Mandy Guo ADDRESS: dchambers@dealeyrenton.com <br />Oakland CA 94604-2675 INSURERS AFFORDING COVERAGE NAIC # <br />INSURERA: Travelers Property Casualty Cc ofAmeri 25674 <br />INSURED NINYOMOORI <br />INSURER B: American Automobile IAS. Co. 21849 <br />Ninyo & Moore Geotechnical & <br />Environmental Sciences Consultants INSURER C: Evanston Insurance Company 35378 <br />475 Goddard, Suite 200 INSURER D: <br />Irvine CA 92618 INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 895533942 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />AD DL <br />IN D <br />SUBR <br />wVD <br />POLICYNUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />6308986R247 <br />10/3/2018 <br />10/3/2019 <br />EACH OCCURRENCE $ 1,000,000 <br />CLAIMS -MADE OCCUR <br />DAMAGE TORETED <br />PREMISES Ea oNccurrence $ 1,000,000 <br />MED EXP (Any one person) $ 10,000 <br />X Contractual Liab <br />X OCP <br />PERSONAL & ADV INJURY $ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $ 2,000,000 <br />POLICY [X]PE� [] LOC <br />PRODUCTS - COMP/OP AGG $ 2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />Y <br />Y <br />810898613247 <br />10/3/2018 <br />10/3/2019 <br />COMBINED SINGLE LIMIT <br />Ea accident $ 1,000,000 <br />BODILY INJURY (Per person) $ <br />X ANY AUTO <br />OWNED SCHEDULED <br />. AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) $ <br />X HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE $ <br />Per accident <br />$ <br />A <br />X UMBRELLA LIAB <br />X <br />OCCUR <br />Y <br />Y <br />CUP9J428527 <br />10/3/2018 <br />10/3/2019 <br />EACH OCCURRENCE $ 9,000,000 <br />AGGREGATE $ 9,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />Y <br />SCW0021231801 <br />5/1/2018 <br />5/1/2019X <br />PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT $ 1,000,000 <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />N <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br />C <br />Professional Liab <br />Y <br />MKLV7PL0003340 <br />10/3/2018 <br />4/3/2020 <br />$5,000,000 per Claim <br />& Contractor's <br />$5,000,000 And Aggr <br />Pollution Liab. <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />REF: Project #051 RV03-00713 / A-2016-113 / RFP #18-043 / NIT I City of Santa Ana I On -Call Various Environmental Services. <br />GENERAL LIABILITY/AUTOMOBILE LIABILITY ADDITIONAL INSURED: City of Santa Ana, its officers, employees, agents and representatives. General <br />Liability is Primary/Non-Contributory and severability of interests applicable per policy form wording. <br />Cancellation: 30 Day/10 Day for Non -Payment of Premium. <br />REVIEWED BY: EUNICE HEREDIA (PG' OF'U� i <br />fill 3►ili li 9G1 G. 01OF-1t LUJI9 MINA P.v�►L�1•lel lll?V�cH�►N]•t�:.Vt•]�Jc-11i <br />City of Santa Ana <br />ATTN: Leticia Lopez <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />
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