|
FEHR&PE-01
<br />SEITA
<br />�yenIVID 9 )
<br />A� CERTIFICATE OF LIABILITY INSURANCE
<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 a .
<br />PRODUCER License s OES7768
<br />c ACT Gigi Yuen
<br />IDA387 Insurance Services
<br />Suite 200 Hopyard Road
<br />Suit
<br />PN"C°Nx , em: (925) 660-3514 50008 FAIIC N° :(925) 416.7869
<br />.Gigi.Yuen@ioausa.com
<br />Pleasanton, CA 94588
<br />IN U R AFFORDING COVERAGE
<br />NAICY
<br />INSURER A:RLIInsurance Company
<br />13056
<br />_
<br />INSURED
<br />INSURER a: Hartford C sualty Insurance Com any
<br />29424
<br />INsuRenc:Liberty Insurance UnderwritersInc
<br />19917
<br />Fehr &Peers
<br />INSURER D:
<br />100 Pringle Avenue, Suite 600
<br />Walnut Crook, CA 94596
<br />INSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WRH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INS&
<br />TYPE OF INSURANCE
<br />IADDLNSD
<br />BR
<br />POUCYNUMBER
<br />POLICY EFF
<br />POLICY UP
<br />LIMITS
<br />A
<br />X
<br />COMMMrAALGENERALUABILM
<br />CLAIMS -MADE OX OCCUR
<br />PSB0006683
<br />12/612019
<br />121612020
<br />EACH OCCURRENCE
<br />S 2,000.000
<br />pAMAGETORENTED
<br />1,000,000
<br />MED EXP An pro
<br />S 10,000
<br />PERSONAL&ADVINJURY
<br />S 2,000,000
<br />GEN'L AGGREGATE LpIMIT. APPLIES PER
<br />POLICY EXI JECpT E] LOC
<br />GENERAL AGGREGATE
<br />S 4,000,000
<br />PRODUCTS . COMP,OP AGG
<br />4,000.000
<br />S
<br />OTHER
<br />A
<br />AUTOMoaLLE
<br />LMB,n,
<br />COdSINEOSINGLE LIMIT
<br />U
<br />S 1,000.000
<br />9GI IWURY Per anon
<br />s
<br />ANY AUTO
<br />PSA0002276
<br />12/6/2019
<br />1216/2020
<br />BODILY IWURY Par ac n
<br />S
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTO
<br />SyM�
<br />E I MACE
<br />S
<br />X
<br />AIROS ONLY X ANFTOS ONLD
<br />A
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRE E
<br />S 5,000,000
<br />X
<br />EXCESS UAa
<br />I
<br />CLAIMS -MADE
<br />PSED002889
<br />1216/2019
<br />1216/2020
<br />AGGREGATE
<br />S 5,000,000
<br />OED I I RETENTIONS
<br />B
<br />WORKERS COMPENSATION
<br />AIDEMPLOYERVUABILITY YON
<br />ANY PROPRIETORIPARTNERr ECUTIVE ❑
<br />WpFIFICcE"EgRV EXCLUDED?
<br />IMntlato 4I1 NNNN
<br />NIA
<br />7WEGZJ1989
<br />5/112019
<br />51112020
<br />X PER OTH-
<br />EL EA HA II)ENT
<br />1,000,000
<br />EL DISEASE EA EMPL YE
<br />1,000,000
<br />II YYea. deaoax wmr
<br />DESCRIPTION OF OPERATIONS Mi.
<br />E L DISEASE. POLICY LIMIT
<br />S 1,000.000
<br />C
<br />Professional Liab.
<br />AEXNYABEFJ2004
<br />1121612019
<br />1216/2020
<br />Per Claim
<br />6,000,000
<br />C
<br />Professional Liab.
<br />AEXNYABEFJ2004
<br />17J6I2019
<br />1216/2020
<br />Aggregate
<br />6,000,000
<br />DESCMPnM OF OPERATION31 LOCATDNS I VEHICLES (ACORD 101, AddalP I Ram &$ Uhedu , may b aaacMd o m°n eryce la , uind)
<br />RE: P19.1593 Santa Ana On -Call VMT
<br />All Operations of the Named Insured, including the aforementioned project, if any.
<br />General Liability: Please see blanket Additional Insured endorsement attached; such coverage Is Primary and Non -Contributory, as required per written
<br />contract.
<br />Auto Liability: No company owned vehicles. Please see blanket Additional Insured endorsement, as required per written contract.
<br />GENERAL LIABILITY & AUTO LIABILITY INCLUDE THE FOLLOWING PERSON(S) OR ORGANIZATIONtS): The City of Santa Ana, its officers, employees,
<br />agents and representatives, as required per written contract
<br />30-0ay Notice of Cancellation is included per policy previsions.
<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 />3 2019
<br />City of Santa Ana AUTIIORQEO REPRESENTATIVE
<br />Risk Management Division, 4 '
<br />20 Civic Center Plaza SAMANTHA M. LAMBE
<br />ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|