NICHCON-02
<br />/��
<br />CERTIFICATECERTIFICATEOF LIABILITYINSURANCE
<br />MCGRAWN
<br />OATE1 01VYYS'}
<br />9f1112112tlfi9
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATEHOLDER, - - -
<br />IMPORTANT: If the, certificate holder Is an ADDITIONAL INSURED, the po8cy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject.. to the terms and conditions of the policy, certain policies may require an endorsement A.statement on
<br />this certificate does not confer rights to the Certificate holder In 8eu of such endorsement($
<br />PROOUCER%icehso# PES7799 .__.
<br />IDA Insurance Services
<br />4370 La Jolla Village Drive
<br />Suite 000
<br />San Diego, CA$2122,
<br />C c>'. Erica
<br />Wlison
<br />NooNr ,Exf:
<br />858 764-006350233 Ar}c Nn (619 :674-6288
<br />E Er
<br />—^—
<br />ea.Wilson lmi ustrorm
<br />iNaUrsERlstnvPo, RaiNo ppyt:Rgga.
<br />Alr
<br />IN LI ERn RLl lnsuraneeCompany
<br />13068
<br />INSURED -
<br />Nichols Consulting Engineers, CHTO.
<br />1885$, Arlington. Ave.,#111
<br />Rego, NV 89509
<br />su RE R 8 1 Crum & F0I'SlES_paciaitkinsuranca ComPan
<br />445 0
<br />uas MIND!
<br />.,.-..
<br />INSUI £
<br />INSURER i
<br />INSURER F r
<br />CERTIFICATE NUMBER, F{i,((StoN rIumts
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI01)
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OT.HERDOCUMENTWITH RESPECTTOWHICH THIS.
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HFREINIS-SUSJECTTOALLT$ETERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN: REDUCED BY PAID CLAIMS:.
<br />INSR
<br />TYPa OP MBURANCa
<br />AD LSUER
<br />POLICY NUMBER .
<br />:...POLICY EFF.
<br />POLICY EX
<br />LIMITS.
<br />A
<br />IXECOMMENCI.ALOUNE.ULCY
<br />DN.MOE OCCUR
<br />nk
<br />PSBQ003222
<br />5117/2019ntLiab/$ev,F6
<br />I
<br />/1712$2$
<br />AC U ENCE
<br />0
<br />1x$0$I$0A
<br />MED EXP (m RWe L1 cnl
<br />.....�._..
<br />3:,,—
<br />...
<br />R. ADVtNJt�7
<br />1,00$,t160
<br />�
<br />GENLAGGREG ELIMtTAPP SFER:
<br />POLIGVx dLT LOG
<br />. OTHER
<br />2,0 0,$00
<br />- OMP P
<br />2,$$$"00$
<br />DodUCtible
<br />,0
<br />A
<br />AUTOM081LELIABlUTY
<br />OMOINEOSINGLE LIMIT
<br />t,OQ$,$$0
<br />goiLYI RYPer asnn
<br />If
<br />X
<br />ANYAUTO
<br />SCHESot1LE0'.
<br />AUTWONLYPx
<br />'AM Aq, novels
<br />wo
<br />x
<br />PSAi)601184
<br />��
<br />6/1712019
<br />'611712020
<br />Y INJURY'Peraculmni
<br />§;_,,,,,_„`_
<br />a EdR at AGE
<br />X
<br />UMBRELLA UAB X OCCUR-
<br />EXCESS UFa CLAIMS.MADE
<br />PSE0003030
<br />8117/2019
<br />W1712020
<br />ACH OCOURRENf'E
<br />1-6,000,000
<br />AGGRE©Are.
<br />s _ 61000,000
<br />ET
<br />DEO Fx RENTIONS 0
<br />A
<br />WORKER5 COMPENSATION
<br />NDEMP OC101MS'LIA LOA
<br />ANYPRCPRIarORIPARTNERIEXECUTIVe YI
<br />F{ ER)M %I
<br />(ManS1a<on'EIn NHR EXOLttO542 N
<br />lryEas damdantInd.
<br />S RPTIONO OPERATI0N5 elow
<br />naA
<br />X
<br />..
<br />PSW0001965
<br />y
<br />15/17/2019
<br />)
<br />511712020
<br />_,_,
<br />OTH-
<br />L. AG ZCNT
<br />£ 1,066,00¢
<br />.
<br />1,040,0 $
<br />_
<br />E.L ISEASE-POLICY �1 tT
<br />11000,000.
<br />B
<br />Prof Liob/Cims Made. -
<br />PKC108625
<br />517/2019
<br />4117/2020
<br />Per Claim
<br />2,000,000
<br />8
<br />Dada$1OkPer Claim
<br />PKC108825
<br />5/17/2019
<br />SM7/2020
<br />Aggregate
<br />2,000,000
<br />OFOF OPERATIONS I LOCATIONS [VEHICLES (AOOM 101, AddaPonul Ramarke Sohedute,!nay tja attachod if Mom Spam is repuirad)
<br />Re: AIi Operafions .
<br />City of Santa Ana, its officers,: employees, agents and representatives are Additional Ipsuredswith respect to General and Auto Liability partite attached
<br />endorsements as raouired by written contract. Insurance Is Primary and Non -Contributory. Waiver of Subrogation applies to Workers' Componsation.
<br />30 bays Notice of Cancellation With 10 Days Notice for Non -Payment of Premium ill accordance with the policy provisions.:
<br />REVIEWED & APPROVED
<br />C RTIP CATS HOLDER... v,BY RiskMANAGEMENT iVISION CANCELLAPPN
<br />_
<br />SHOULD ABOVE DESCRIBEDPOLICIESCANCELLED BEFORE
<br />THEIN
<br />TE THEREONOTICEIWLBE DELIVERED
<br />EXPRDATE
<br />ACCORDANCE WITH THE POLICY PROVIStCN9,
<br />City Of Banta Ana SAMA e HA M, LAMBER
<br />Risk Management Division
<br />20 Civic Cantor Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />.._.1SantaAna-0A927n2 —
<br />—.
<br />ACORD.26 (2016103) Ud 1908-2016 ACORD CORPORATION. All rights reserved,
<br />The ACORD name and logo. are registered marks of ACORD
<br />
|