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JOHNSON FRANK & ASSOCIATES, INC. 5-2008
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JOHNSON FRANK & ASSOCIATES, INC. 5-2008
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Last modified
1/3/2012 2:52:13 PM
Creation date
5/8/2008 4:22:20 PM
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Contracts
Company Name
JOHNSON FRANK & ASSOCIATES, INC.
Contract #
A-2008-070
Agency
PUBLIC WORKS
Council Approval Date
4/7/2008
Insurance Exp Date
12/1/2009
Notes
w/c exp - 1/1/2010
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ATTACHMENT "C" <br />Sample Certificate of Insurance <br />ACORD,~ CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDDlYY) <br />01131 /2001 <br />PROOUr.ER THIS CERTIFICATE IS 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 />~ INSURERS AFFORDING COVERAGE <br />INSURED - - .._ _ _ _- <br />_.._-. <br />INSURERA ._.- <br />_._._ <br />UJSURER B. <br />I INSURER C. - <br />INSURER U <br />INSURER E <br />COVERAGES <br />THE POLICIES OF tN5URANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR Th{E POLICY PERIOD fNDICATED. NOTW171iSTANQING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 1NHICH THIS CERTIFICATE MAY BE ISSUED OR <br />h1AY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEQ HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES 4GGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />VSR _._._-----.._. ..-_.___.._ <br />_ . _ .- ~-- <br />PDUCY EFFECTIVE-~ POUCY EXPIRATION I - -~ ~ ~~ -~ "-~- - <br />.jg YPE OF INSURANCE POLICY NUMBER DA tMMIODfYY1 <br />! GENERALLUBtUTY X111111111 UMrrS <br />r --~ ~ ~ ~ 01/01/2001 ~ 01!01!2002 EACNOCL'URRENCE _ _._._.- 1 S . _...._. 1 000,000 <br />x ~ COMMERCIAL GENERkL_l1ABILiTY ~ : ------- <br />1 __~C~AIMStdACE ! X~I ,..I ~ !~FIREOAMAG£IAny_onefirej iS.-_. 50,000 <br />, ._! OCCUR ' I - .__ ___---.._. <br />I , , MED ExP {Any orer, (+ersrn} ! 5 5,000 <br />i <br />1 ~ ~ - ~ PERSONAL&ADVIhIURY 5 1,000,000 <br />I ~ { r ._._- - _. _.-._ <br />! ... _.. _ -.- ~ - I GENERAL AGGREGATE ~ [ 2.000,000 <br />~ENl. P.Cr REGAl'E UMIT APPI_lES'ER ~ ~ I ~--- -- - ._.. ' _-- _ _. <br />! I "PRO- ~ ~ f, PRODUCTS COMP OF AGG 1 5 2 000,000 <br />j AUTOMOBILE UABtUTY ' <br />I_X <br />~ ,ANV AUTD <br />i ALL 6t.'rJEC AUTOS <br />I ~ SCHEDULED AUTOS <br />~ ~ HIF(_D AUTOS <br />NOIJ-AWNED AUTOS <br />I <br />GARAGE LIABILITY <br />ANV AUTO <br />~ - i <br />j <br />I <br />i EXCESS LIABILITY <br /><-I Oi•CUR ~-_j CLAIMS MADE ~ <br />DEDUCTIBLE <br />X222222222 101/01/2001 + 01/01/2002 <br />SEE ATTACHED ADDITIONAL <br />INSURED ENDORSEMENT <br />I COMBiNEO SINGLE LIMIT S 1,000,000 <br />(Ea arrxlnnl} <br />_..: _._ ~_.. ... ______..__. ..i <br />BODILY IN.IURY + ,~ <br />(PClr person} <br />. BODILY INJURY i S <br />. (Peracz7tln~v} <br />PROPERTY DAMAGE I L <br />(Per aCadeni) I <br />r AUTOONLY~ EA.4CCIDLNT $ <br />__._ ---- <br />_ --- <br />. OTHER THAN EA ACC 1 $ <br />' - I ----- ._.---_ <br />j AUTO ONLY A ,, p <br />I EACH OCCURRENCE <br />COVERAGES DEPEND ON TYPE AGGPEG/±iE _._ __. ~ $__---- ..__..___--- <br />_; <br />~ <br /> <br /> <br />OF AGREEMENT/CONTRACT ~ --- - <br />4---.... __,_._ _ <br />_ <br />____ <br />_ _-_-- <br />-r ~ ---- ----- <br />._ ~ S _.. __._..__._~__....._._._. <br />WORHERSCOMPENSATIONAND ! XXX333333333 01lOV2001 i 01/01/2002 <br />i EMPLOYERS' UABILrrY I <br />i <br />1 <br />Drn£R ~ PL44444A <br />01!01/2001 f 61/01/2002 <br />! Professianat LiaUility <br />1 i <br />i <br />6ESCRIPTION Of OPERATIONS/L,OCATION5IVEHICLES/EICCLUSIONS ADDED BY ENDORSEMENTISPECIAL PRDY1510N5 <br />Certificate hlrslder is additional insured ~r attached. <br />Project No. <br />HOLDER <br />City of Santa Ana <br />24 Civic Center Plaza -Ross Annex (M- <br />Santa Ana, GA 92741 <br />x YJG STA LU- !OTM•' <br />-_ QBYlftdlYS.L_-.1._EB_4,_.___._ -- <br />_-.__. <br />_._. <br />E L. CACH ACCIDENT - ~ $ <br />_._~ __.__-.T -. 1,000,000 <br />_ <br />! E L. DISEASE - EA EMPL6YEEal S 1,000,000 <br />E.L DISEASE - POLICY LlIdIT ~ S 1.000,000 <br />!Each Occurrence 1,000,000 <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE F~CPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILLS MAIL ~Q_ bAYS. WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT <br />AUTHORED REPRESENTATNE <br />ACORD 25-S (7197) ®ACORD CORPORATION 1 <br />
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