|
Francine H. Villareal Villareal
<br />A�� �® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DO/YYYY)
<br />a/22/2021
<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(les) 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
<br />Dealey, Renton & Associates
<br />P. O. Box 12675
<br />Oakland CA 94604-2675
<br />CONTACT
<br />NAME:
<br />PNCNE . 510-465-3090 FAX No). 510-452-2193
<br />E-MAIL
<br />ADDRESS: certifcates deale renton.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIL#
<br />INSURERA: Travelers Property Casualty Company of America
<br />25674
<br />LICE #: 0020739
<br />INSURED NINY&MO-01
<br />Ninyo & Moore Geotechnical &
<br />Environmental Sciences Consultants
<br />INSURER B: Evanston Insurance Company3$378
<br />INSURERC: Travelers Casualty and Surety Co of America
<br />31194
<br />INSURER D:
<br />475 Goddard, Suite 200
<br />Irvine CA 92618
<br />INSURER E:
<br />INSURER F:
<br />l Vvc GES CCKIIFICAIC NLJMBtH[1g89Rl5797 DC\1ICInk1 Ml ua000.
<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 />ADOL
<br />SUBR
<br />POLICY NUMBER
<br />MWDDIYYYY
<br />POLICY UP
<br />MM/DDfYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />6308986R247
<br />10/3/2020
<br />10/3/2021
<br />EACHOCCURRENCE
<br />$1,000,000
<br />CLAIMS -MADE T OCCUR
<br />AMAGET ENTED
<br />PREMISES Ea occurrence
<br />$1,000,000
<br />X
<br />MED UP (Any one person)
<br />$10,000
<br />Contractual Liab
<br />X
<br />OCP
<br />PERSONAL INJURY
<br />$1.000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />AGGREGATE
<br />$2.000,000
<br />POLICY�jEO LOC
<br />S-COMP/OP AGG
<br />$2,000.000OTHER:
<br />$A
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />8107NO33091
<br />10/3/2020
<br />10/3/2021
<br />D SINGLE LIMIT
<br />$1,000,000ntANY
<br />AUTO
<br />MOM
<br />JURY(Per parson)
<br />$OWNED
<br />SCHEDULED
<br />AUTOS ONLY AUTOS
<br />JURY(Per accident)
<br />$HIRED
<br />X NON -OWNED
<br />ONLY AUTOS ONLY
<br />Y -DAMAGEAUTOS
<br />ent
<br />$
<br />A
<br />X
<br />oMBRELLALIAS
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CUP9J428527
<br />10/3/2020
<br />10/3/2021
<br />EACH OCCURRENCE
<br />$9.000,000
<br />AGGREGATE
<br />$8,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I I RETENTION$
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />Y
<br />UB6P428399
<br />5/1/2021
<br />1/1/2022
<br />X STATUTE
<br />AND EMPLOYERS' LIABILITY Y/N
<br />ERH
<br />E.L. EACH ACCIDENT
<br />$1,000,p00
<br />ANYPROPRIETOR/PARTNER/EXECWIVE N
<br />OFFICER/MEMBEREXCLUpEp? ❑
<br />NIA
<br />E.L. DISEASE - EA EMPLOYLE
<br />$1,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />8
<br />Professional Uab.&
<br />Y
<br />MKLV7PL0004694
<br />5/1/2021
<br />10/3/2022
<br />Per Ciaim
<br />5,000,000
<br />Contractors Pollution Liab.
<br />Computer Network Security
<br />Annual Aggregate
<br />5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Umbrella Liability policy is a follow -form to underlying General Liability/Auto Liability/Employers Liability.
<br />REF: N&M Project #051RV03-00713 / RFP #18-045 / A-2016-113 / A-2018-189 / A-2018-191 / City of Santa Ana / 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. Waiver of Subrogation applies to Commercial General
<br />Liability, Automobile Liability and Workers Compensation. Cancellation: 30 Day/10 Day for Non -Payment of Premium.
<br />CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Department
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702 RttlR 1 �� adD
<br />V19.4,Vn111_,(.�t-�lY-Jfti 3van.x._p N
<br />`�IY REVIEWED & APPROv®BY:
<br />©1988-2015 ACORD C , il11111 ,. ,
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD '' Risk Management Analyst
<br />
|