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NATIONAL DATA & SURVEYING SERVICES 2 - 2011
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NATIONAL DATA & SURVEYING SERVICES 2 - 2011
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Last modified
6/10/2014 5:10:54 PM
Creation date
10/5/2011 12:06:41 PM
Metadata
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Template:
Contracts
Company Name
NATIONAL DATA & SURVEYING SERVICES
Contract #
N-2011-119
Agency
PUBLIC WORKS
Expiration Date
6/30/2012
Insurance Exp Date
9/17/2013
Destruction Year
2017
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-���� _ - <br />`�_ -_� CERTIFICATE OF LIABILITY INSUR_ aNCE <br />DATE (MMIDD/WYY) <br />e /i9 /zoiz <br />THIS CERTIFICATE is 7SSUED AS. A MATTER- OF INFORMATIOfV ONLY AND. CONFER$ NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS - - <br />OERTIFICATE OO ES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. -THIS CERTIRCATE OF INSURANCE GOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING [NSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, ANO THE CERTIFIGATE.�. HOLDER <br />IMPORTANT: H the certlflcata holder Is an ADDITONAL INSURED, the pollcy(jes) must be endorsed.. If SUBROGAI"ION IS WAIVED, subject to <br />the farms end condlt[ons of 2ha podcy, cattalo policies may require an endorsement Astafamant on this eerUneate does not confer rjghb to the <br />- carOficate holtler [n Ilau of such andorsemant(s). - <br />PRODUCER <br />ROSEWOOD RTSK MGMT8L INS SOLUTIONS <br />7162 Beverly Blvd, Ste 180 <br />Los Angeles, CA 90036 <br />OH38S77 <br />NAME- Ye u a Kaplan <br />PH (323)899 -3081 � �; No), 323 800 -6745 <br />A/C Nq EIC. <br />ADDRESS Y ap_an rrmjs.com <br />INSURER{Sj AFFORBING 4�OVERAGE <br />NAICY <br />INSURER A� Travelers Property Casualty. Co. of America <br />2 674 <br />INSURED National Data and Surveying Services <br />INSURER B: rave ers rope suety o. o menca <br />EACH, OCCURRENCE <br />8370 Wilshire Blvd_, Ste 205 <br />wsuRER c: raveers roperty sue y o. o menca <br />_ <br />Beverly Hills, CA 90211 <br />INSURER D: -rave ers roperty sue ty o. o merica <br />(323) 782 -0090 <br />INSURER E: <br />PREMISES (Ea occurronre <br />INSURER. F: <br />MED EXP (Arty onapa,sm) <br />E S,DOI� <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSVRANCE LISTED BELOW HAVE BEEN ISSVED TO' THE INSURED NAMED ABOVE FOR 7HE POLICY PERIOD ' <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR- OTHER. DOOUMENT 1MTH RESPECT TO WHICH THIS <br />' CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUSJEGT TO ALL THE TERMS. <br />EXCLVSIONS AND CONDITIONS. OF SUCH. - POLICIES. LIMITS SHOWN. MAY HAVE BEEN REDUCED BY PAID CLAIMS. ' <br />INSR <br />LTR� <br />TYPE OF INSURANCE <br />g <br />11VNn <br />POLICY NUMBER. <br />(MM /DD/Y <br />- MN/pDA'YYl7 <br />LIMITS <br />' <br />GENERAL LIABILITY - _ <br />EACH, OCCURRENCE <br />$ 1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMSMADE OCCUR <br />PREMISES (Ea occurronre <br />E 300y000 <br />MED EXP (Arty onapa,sm) <br />E S,DOI� <br />A <br />Y <br />�, <br />680- 6A814536- TIL -12 <br />/1? /zolz <br />/17/2013 <br />PERSONALAADVINJURY <br />E 1,000,000 <br />GENERAL AGGREGATE <br />$ Z,�O�i�O <br />GEN'L AC- .C'REGATE LIMIT APPLIES PER:. <br />PRODUCTS - COMPIOP AGG <br />S , <br />X POLICY PRO- LOC <br />$ <br />AUTOMOBILE LIABILITY <br />Ea acddak <br />$ � � <br />B <br />X ANYAUTO <br />ALLOwNED scHEDULEO <br />AUTOS X AUTOS <br />Y <br />Y <br />BA- 6A815938 -12 -CRP <br />/17/2012 <br />/17/2013 <br />BODILY�gNJURY (Per person) <br />$ <br />BODILY INJURY (Pe[acdderA). <br />$ <br />NON - OWNED <br />X HIRED AUTOS X AUTOS <br />(PerOa¢Itl t]DAMA <br />E <br />$ <br />C <br />A <br />UMBRELLA UAB <br />Excess LUe <br />OCCUR <br />CLAIMSJuIADE <br />CUP- 7A337319 -12 -47 <br />/17 /zOY2 <br />/17/z013 <br />EACH OCCURRENCE <br />S / <br />X <br />AGGREGATE <br />$ <br />DED <br />RETENTION E- � <br />E <br />8 <br />VbORKERS COMPENSATION <br />AND EMPLOYERS DABILITY Y,N <br />ANY PROPRIETOq/PPRTNERIEXEGUTIVE � �. <br />OFFlCERMEMBER F�(CLUDEDi <br />IN rA <br />Y <br />'T �t <br />x�uB- 3793.1 H9 -H -lL <br />_ <br />/1%/2012 <br />/17/213 <br />VbC STATU- TH- <br />TORY LIMITS ER <br />EL PJ,CH ACCIDENT <br />E <br />E.L. DISEASE- EA EMPLOYEE <br />S <br />(Marta atcry In NHj <br />If Yes, desaihe under - <br />EL DISEASE- POLICY LIMIT <br />E / <br />DESORIPr10N. OF OPERATIONS trelgw <br />� <br />DESCRIPTION OF OPERATIONS ILOCATONS /VEHICLES (Atuarh ACORD tot, Adtlltional RernerNS SrJietlrM,k maraspaca is required) <br />The City of Santa Ana, is provided additional insured status on a prlmaryand APPRQ� <br />noncontributory basis as required by written contract or agreement. A /( <br />Waiver of Subrogation is in favor of the additional insured. 30 Days Notice of (I( <br />Cancellation, 10 Days for Non Payment of Premium. Laura 9fit{ g t.dy <br />Ref: Agreement N- 2011 -119 TrafficCOUnting and Data Collection Services �-- bis{ass{ Ci {$r �4tDrid�y: <br />LACK 1 IrILN I C rYVLUCK GANGtLLA I ION <br />City of Santa Ana - <br />20 Civic Center PIa �- ..8065 AnneX SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED- BEFORE <br />l� THE EXPIRATION DATE THEREOF, NOTICE 1M1LL BE DELIVERED IN <br />(M) r 1 " � - ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 9��`bl' <br />- ` ) _.__� t `I `.- AUTHORIZED REPRESENTATIVE <br />©'1988 -2011} ACORD CORPORATION. All rights reserved_ <br />ACORD25 (20'10/05) The ACORD name and logo are registered marks of ACORD <br />
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