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RINOCON-01PHILI
<br />C -EY, - ERTIFICATE OF LIABILITY INSURANCE �..
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<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
<br />BELOW. 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
<br />pofty(les) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of
<br />the Policy, certain policies, may require an endorsement. A statement on
<br />this certificate, does not confer rights to the Certificate holder In lieu of such
<br />endorsemermYsi.
<br />PRODUCER License # OE67768
<br />C TACT Elizabeth Leach
<br />Liaends Environmental Ins. Services
<br />130 Vantin
<br />PHONE
<br />JA#c, No. exit: (949) 297.5537 52011 Nol,(949) 297 -5960
<br />Suite 250E
<br />MA
<br />JM-f'kS.L Eliza —beth - Leach QL0a
<br />Aliso Viejo, CA 92656
<br />—Usa-Com
<br />INSURER A. Crum & Forster eClalty Insurance Coapn)L
<br />INSURED
<br />I
<br />Trumbull Insurance �27120
<br />Rincon Consultants, Inc.
<br />210 N Ashwood Ave
<br />INSURER c:AtairStone National lnsqLance C�omPL3!2y— 25496
<br />Ventura, CA 93033
<br />IN S2RER D;
<br />[---
<br />!�QIF 4,000,000
<br />INSURPR 15
<br />F �7,
<br />POLICY Lo
<br />ry Contractors PoiJon L�iabffln�
<br />:111:�:IR�R F
<br />COVERAGES CERTIFICATE NIJMRFR- cc flive-11,1 1,11 ImAra—
<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 NOTW'CHSTANDiNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHERDOCUMIHNTWITH 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />MISR,
<br />ADDLISUBR
<br />POLICY NUMBER
<br />POLICY EFFJ "'POLICY EXP
<br />LIMITS
<br />-Lig_TYPEOFINSURANCE
<br />A
<br />X COMMERCIAL GENERAL WABILiry
<br />-IMM1QDN`YYYI
<br />a4MLQP=.I
<br />CCURHtEN E 3,000,000
<br />CLAIMS -MACE '7X OCCUR X X EPKI14165
<br />0912 7J2016
<br />09122J2018
<br />DAMAG= TO RENTED
<br />'REW'$-E 50,000
<br />X Transporation Poll,
<br />%IFO FXP [Anv or, 10000
<br />s
<br />�OY.It, LAIRY -S 3,000,000
<br />GEN't- AGGREOATE� UNItT APPLIES PER,
<br />-I
<br />!�QIF 4,000,000
<br />F �7,
<br />POLICY Lo
<br />ry Contractors PoiJon L�iabffln�
<br />��AL,��LQRE.r
<br />4,000,000
<br />I A I OHER
<br />,Deductible 2,500
<br />�±YTOMOSKE LIABILInY1,000000
<br />CFOMINED *SINGLE LANT
<br />X i ANY AUTO
<br />x
<br />x 172UUNPT4318
<br />12/1712016 12/117=17'
<br />FOOILY INJURY
<br />CAINECAINE D SCHEDULED
<br />ALTO$
<br />HRI�D x N
<br />AUT US ONLY -!2�1 061 'Cj N4�
<br />Eqn9cail Dad
<br />A_.
<br />UMBRELLA LIAB 1 x � OCCUR
<br />X EXCESS LIAB —JC
<br />L S MACE
<br />1
<br />06084
<br />109/2Z2016 0912212017
<br />�ctiEFX1
<br />s
<br />51 00,000
<br />5,000,000
<br />AGGREGATE
<br />CEO I X I REI-ENTIONS
<br />C
<br />WORKERS COMPENSATION
<br />X SPTARTU7E OTH.-
<br />AND EMPLOYER$'LIASILITY YIN
<br />ANY PRCPR1ETOR,PARTNERiEXFCUTIVE F-1
<br />x
<br />T10170329
<br />0210112017
<br />02JO112018
<br />�AL. EA FI IDENT
<br />—
<br />3 1,000,000
<br />,,-rll� a F�'rJ Eke, L 1
<br />R e n
<br />NIA
<br />L ",
<br />E.L. DISEASE EA EMPLO
<br />110030,01060
<br />YYA�fp
<br />des urder
<br />F 1-. DISEASE - POLICY LIMIT S 1,000,000:
<br />ona
<br />SCJRIPTICNC�.SPR RATICNS below
<br />A (Professional
<br />Liab.*
<br />i EPK,114155
<br />0912212016
<br />Ul—212018
<br />Per Claim 3,000,000,
<br />A iPmfiessional
<br />Liab,*
<br />IEPI(114155
<br />0912212016;
<br />0912212018
<br />Aggregate 4,000,000
<br />. . ..........
<br />DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES JACORD 101. Additional Remarks Schedule. may be AftAched H inure space Is required)
<br />Liability and Transportation Pollution are written on a Claims Made basis. When required by written contract, the General Liability and Pollution
<br />(*Professional
<br />Liability Limits are on a Per Project basis while dedicated; the Professional Liability is on a Per Policy basis.
<br />The City of Santa Ana and Community Development Agency, 20 Civic Center Plaza, M-26 Santa Ana, CA 92702, their officers, employees, agents and
<br />volunteers are Included as additional insureds for General Liability and Auto Liability with respect to work performed for them by the Named Insured as,
<br />required by written contract, per Blanket Additional Insured endorsement CO20100704, 0020370704 & HA99160312. Liability Coverage Is Primary and Non -
<br />Contributory as required by written contract, per endorsement CFENV 01 036 10 13 & HA99160312. Blanket Waiver of Subrogation applies to General Liability,
<br />SEE ATTACHED ACORD 101
<br />SHOULD ANY OF THE AE30VE DESCRIBE[) POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />REPRESENTATIVE
<br />City of Santa Ana
<br />20 Civic Center Plaza, M-26
<br />ACORD 26 (2016103) (D 1988-2015 ACORD CORPORATION, All rights reserved,
<br />The ACORD name and logo are registered marks of ACORD
<br />',A
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