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<br />Q
<br />
<br />Client#: 6255
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />RBFCONSUL
<br />
<br />PRODUCER
<br />Dealey, Renton & Associates
<br />P. O. Box 10550
<br />Santa Ana, CA 92711.0550
<br />714427.6810
<br />
<br />DATE (MMJDDfYY)
<br />
<br />11/29/04
<br />
<br />THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />! INSURERS AFFORDING COVERAGE
<br />.. t,m,... _.'.n__..__._.__.._'____n._'_....
<br />i INSURER A: Travelers Property Casualty ~~~~~.!.\!':1_~..
<br />INSURER 8: Hartford Fire Ins. Co.
<br />INSURER c: Fireman's Fund Insurance Co.
<br />-- ----------
<br />INSURER D" Underwriter~ at L_19Y~_~s of_~ondon
<br />INSURER E
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />Iri: I TYPE OF INSURANCE POLICY NUMBER Pg..i!flt~~5~R-~T IP~~$ll~';}~l,l~N
<br />A 'GENERAL LIABILITY !P630500D409204 '11/30/04! 11/30/05
<br />I X COMMERCIAL GENERAL LIABILITY I I
<br />CLAIMS MADE , X : OCCUR IINOP. CONTRACTORS I
<br />uXCONTRACTUAL !INCLUDED i
<br />X BFPD,XCU ,
<br />i ,
<br />i i
<br />
<br />ACORD,"
<br />
<br />INSURED
<br />
<br />RBF Consulting
<br />PO Box 57057
<br />Irvine, CA 92619.7057
<br />
<br />COVERAGES
<br />
<br />B
<br />
<br />GEN'L AGGREI~AT~ ~~~~ AP iPLlE~ PER:
<br />POLICY I X I JECT X I LOC
<br />AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />
<br />11130/05
<br />
<br />, 11/30/04
<br />
<br />57UENTL0126
<br />
<br />ALL OWNED AUTOS
<br />
<br />SCHEDULED AUTOS
<br />
<br />: X , HIRED AUTOS
<br />i'X'i NON-OWNED AUTOS
<br />1----,
<br />~---
<br />
<br />,
<br />!
<br />,
<br />
<br />.
<br />
<br />
<br />I.Q.~RAGE LIABILITY
<br />, ANY AUTO
<br />,
<br />,
<br />
<br />i
<br />111/30/04
<br />
<br />A.PPIOVED ASi TO
<br />
<br />,-0
<br />
<br />C i EXCESS LIABILITY XSMOO086597721
<br /> X OCCUR i I CLAIMS MADE Professional Liab.
<br /> is Excluded
<br /> DEDUCTIBLE
<br /> i RETENTION .
<br /> ! WORKERS COMPENSATION AND
<br /> I EMPLOYERS' LIABILITY ,
<br /> i
<br />- i
<br />D OTHER Professional I PI049400
<br /> Liability ,
<br /> i
<br />
<br />11/30/05
<br />
<br />,
<br />/'ui /';1
<br />
<br />v LaUr;~lt Sheedy
<br />
<br />ASSlsta-~ '->ity All
<br />rn , _ orne\'
<br />\ !
<br />
<br />11/30/04
<br />
<br />'11/30/05
<br />!
<br />
<br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />General Liability policy excludes claims arising out of the pertormance of professional
<br />services
<br />Re: IN 10.102081, Design & Development Standards. . City 01 Santa Ana, 20
<br />Civic Center Plaza, Santa Ana, CA 92701, its officers, employees, agents,
<br />(See Attached Descriptions)
<br />
<br />LIMITS
<br />
<br />EACH OCCURRENCE
<br />
<br />.1 000000
<br />'1 000 000
<br />$5,000
<br />11.0.09,000 _
<br />$2,0.0Q,9.0ll___
<br />s.2,-(}QQ1()Q9___
<br />
<br />~~~.~~MA.9.~~~l.~~-.!i.!".eL
<br />
<br />MED EXP (Anyone person)
<br />
<br />PERSONAL & ADV INJURY
<br />
<br />GENEHAL AGGREGATE
<br />
<br />PRODUCTS -COMPIOPAGG
<br />
<br />COMBINED SINGLE LIMIT
<br />(Eaaccidellt)
<br />
<br />'1,000,000
<br />
<br />BODILY INJURY
<br />(Per person)
<br />
<br />,
<br />
<br />BODILY INJURY
<br />(Per accident)
<br />
<br />PROPERTY DAMAGE
<br />(Peraccidenl)
<br />
<br />AUTO ONLY - EA ACCIDENT $
<br />OTHER THAN EA ACC ,$
<br />I AUTO ONLY: AGG j $
<br />! EACH OCCURRENCE ! $10,000,000
<br />~~G.9BE~!E_____ :10..L0.99,0_00_ _..__
<br />
<br />FOR -"
<br />__ - ___ ~___ - __n_n
<br />$
<br />
<br />I WC STATU-
<br />ITnRY liMITS
<br />EL EACH ACCIDEm
<br />
<br />IOJ~'
<br />
<br />EL DISEASE - EA EMPL OYEE $
<br />EL DISEASE - POLICY LIMIT $
<br />$1,000,000 per claim
<br />$2,000,000 annl aggr.
<br />
<br />CERTIFICATE HOLDER
<br />
<br />, AD 0 ITIONAlINSURED; INSURER LETTER:
<br />
<br />CANCELLATION
<br />
<br />
<br />SHOULD ANYQf THEABOVE DESCRIBED POllCIESBECANCELLED BEFORE THE EXPIRATION
<br />
<br />City of Santa Ana, Planning Division
<br />Ms. Maya DeRose
<br />20 civic Center Plaza, Ross Annex Bldg 2nd FL
<br />PO Box 1988, M.20
<br />Santa Ana, CA 92702.1988
<br />
<br />DATE THEREOF, THE ISSUING INSURER WILL:II:K~XlPMAIL30
<br />
<br />DAYS WRITTEN
<br />
<br />NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHELEFT, B~)f)il~~:lKRlXXx
<br />
<br />tueafX~tl(_tIl;KXJl!X"KXMDIJilXlf'Jl!JlXXX~XWX x
<br />ft~)(JA()6.Ux
<br />R E eEl V E 0 AUTHORIZED REPRE'ENT A TIVE
<br />
<br />#Ml15917
<br />
<br />
<br />@ ACORD CORPORATION 1988
<br />
<br />ACORD 25.5 (7/97)1
<br />
<br />012
<br />
<br />DEe 0 ~ 2004
<br />~AtUA ANA PLANNING DE:PI
<br />
<br />BG
<br />
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