Laserfiche WebLink
ACORD CERTIFICATE OF LIABILITY INSURANCE OP IDRBF RC <br />DATE(MMIDD/YYY) <br />RBFCO-1 <br />06 23 09 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />United Captive Ins. Brokers <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />17151 Newhope St., Ste 211 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br />Fountain Valley CA 92708 <br />Phone: 714-708-4370 Fax: 714-708-2300 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />INSURER A: U.S. Fidelity and Guaranty Co. <br />25887 <br />INSURER B: <br />INSURER C: <br />RBF Consulting <br />14725 Alton Parkway <br />Irvine CA 92618 <br />INSURER D: <br />INSURER E: <br />COVERAGES <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 />IN LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MMIDDlYY <br />POLICY EXPIRATION <br />DATE MMIDD/YY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />PREMISES (Ea occurence) <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />4 <br />MED EXP (Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG <br />$ <br />POLICY PRO LOC <br />JECT <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per person) <br />$ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />$ <br />AUTO ONLY: AGG <br />EXCESS/UMBRELLA LIABILITY <br />EACH OCCURRENCE <br />$ <br />OCCUR 71 CLAIMS MADE <br />AGGREGATE <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />A <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />D123WO0187 <br />07/01/09 <br />07/01/10 <br />X TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ 1000000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 1000000 <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1000000 <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />*10 days notice of cancellation for non-payment of premium. <br />Re: Environmental Services and Technical Studies <br />CERTIFICATE HOLDER CANCELLATION <br />CITS•AN2 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL * 30 DAYS WRITTEN <br />City of Santa Ana <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />Attn : Tonia Zerba <br />20 Civic Center Plaza <br />, <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />P.O. Box 1988, M-20 <br />`� Jt'EP <br />ES. <br />AUTFIWIZEDREPRESENTATIVE <br />Santa Ana CA 92702 <br />ACORD 25 (2001108) — _ T A ` © ACORD CORPORATION 1 <br />l.` IP r)t ('I+ ✓-j'_orney <br />