|
(!-may T -Crg
<br />k4i� ..C.,L --
<br />�R°® CERTIFICATE OF LIABILITY INSURANCE
<br />uvvtnAueu ChHTIFICATE NUMBER: REVISION NUMBER:
<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 />DATE
<br />03/06/2014
<br />03/06 /2014
<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 BELOW.
<br />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 be endorsed. If SUBROGATION IS WAIVED, subject to the
<br />terms and Conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsements .
<br />PRODUCER
<br />LEGENDS ENVIRONMENTAL INSURANCE SERVICES
<br />130 VANTIS DR. STE 25
<br />ALISO VIEJO, CA 92656
<br />LICENSE NOC79875
<br />NOMTACT
<br />PHONHFe E F c
<br />-MAIL
<br />DRESS:
<br />INSURER($) AFFORDING COVERAGE
<br />NAIC g
<br />INSURERA: AMERICAN SAFETY INDEMNITY COMPANY
<br />IA IX
<br />INSURED
<br />RINCON CONSULTANTS, INC.
<br />180 NORTH ASHWOOD AVENUE
<br />VENTURA, CA 93003
<br />INSURERS
<br />ENV030030 -11 -01
<br />INSURER C:
<br />_
<br />INSURER O:
<br />$ 3,000,000
<br />uR
<br />50,000
<br />NSURER F:
<br />$ 10,000
<br />uvvtnAueu ChHTIFICATE NUMBER: REVISION NUMBER:
<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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ICTR
<br />TYPE OF INSURANCE aNSR
<br />SUVD
<br />POLICY NUMBER
<br />MMLOO EFF
<br />MOLpCOV YP
<br />LIMITS
<br />A
<br />GENERALLIABILITY X
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OOCCUR
<br />ENV030030 -11 -01
<br />9/22/2011
<br />9/22/2014
<br />EACH OCCURRENCE
<br />$ 3,000,000
<br />DA AGE T RENTED
<br />PREMISES (Ea occurrence )
<br />50,000
<br />MEO EXP IAny one person)
<br />$ 10,000
<br />X CONTRACTORS POLL
<br />PERSONAL BADV INJURY
<br />$ 1000,000
<br />' X
<br />XCU
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER'
<br />X F! POLICY JR� LOG
<br />F
<br />PRODUCTS- COMP(OPAGG
<br />S 4.000,000
<br />i - --
<br />$
<br />A
<br />AUTOMOBILE
<br />1
<br />LIABILITY
<br />i ANYAUTO
<br />ENV03OG30 -11.01
<br />9/22/2011
<br />9/22/2014
<br />pOMBtN SING ELIMI
<br />( GEa acudeoc)
<br />$ 1,000,000
<br />BODILY INJURY (Per parson)
<br />$
<br />'ALLppWNED 9CHEOULEO
<br />A S AUTOS
<br />BODILY INJURY (Per accideall
<br />-'
<br />$
<br />X
<br />HIRED AUTOS X UT
<br />AOS
<br />Pecdet A AGE
<br />r accident)
<br />$
<br />$
<br />A
<br />UMBRELLA UAS
<br />OCCUR
<br />ENUO30031.13 -03
<br />9/22/2013
<br />9/2212014
<br />EACH OCCURRENCE
<br />5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />X
<br />EXCESS Ups
<br />CLAIMS -MADE
<br />DED I X I RETENTION$ 10,000
<br />$
<br />_
<br />1
<br />1
<br />WORKERS COMPENSATION
<br />I
<br />TATU- lH-
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PpROPRIETOR(PARTNERIEXECUTIVE�
<br />EXCLUDED?
<br />(mF OItl �oiYEn NHS
<br />If es, describe under
<br />DESCRIPTION OF PERATION below
<br />NIA
<br />E.L. EACH ACCIDENT
<br />$
<br />E.L. DISEASE - EA EMPLOYEE!d
<br />E.L. DISEASE POLICY LIMIT
<br />is
<br />A
<br />ENVO30030-1 1 -01
<br />912212011
<br />9/22/201411
<br />PETOO DATES: 12/9/94,9/l/08,
<br />PROF LIABILITY/ CLMS MDE
<br />4,000,000 AGG. 3,000,000 EA OCC (PL)
<br />TRANSPORTATION COV, ICLMS MDE
<br />1,000,000 AGG 1,000,000 PER OCC
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (AVach ACORD 1S1, Addhional RemaMa Schedule, H more apace Is requiretl),
<br />THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA, CA 92702; ITS OFFICERS, EMPLOYEES, AGENTS AND VOLUNTEERS
<br />ARE NAMED AS ADDITIONAL INSUREDS ( "ADDITIONAL INSUREDS ") WITH REGARD TO LIABILITY AND DEFENSE OF SUITS - 6y G
<br />REFER O ENDORSEMENT ATTACHED, RFORMED BY OR BEHALF OF THE NAMED INSURED. r".t G-} Y
<br />THE CITY OF SANTA ANA
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
|