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Client#: 388
<br />SALLYSWANI
<br />ACORM CERTIFICATE OF LIABILITY INSURANCE
<br />FATE (MMIODIYYYY
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />6/01/2016
<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 CPA( �E 1?EEI.RHE� pf9 RIG 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
<br />the terms and conditions of the policy, certain policies may require an en T.A6n .. stS h ¢n ltR l440ificate does not confer rights to the
<br />O7"r f ' �'
<br />certificate holder In lieu of such endorsement(s). Of 177171Ir .,, ( ',t_`,
<br />PRODUCER
<br />NAME: Ahgel'a N.' 0;g' -
<br />Dealey, Renton & Associates452
<br />ac°N o ,,,):510465-3090IFAX
<br />ac, No :510-2193
<br />P. O. Box 12675 9 /I vv
<br />N —g`�,� I O
<br />E-MAIL
<br />ADDRFSs: aborg@dealeyrenton.com
<br />Oakland, CA 94604-2675
<br />510 465-3090
<br />INSURERIS) AFFORDING COVERAGE NAIC#
<br />INSURER A: Sentinel Insurance Co. LTD 11000
<br />INSURED
<br />INSURER a o Hartford Ins. Cc of Midwest 37478
<br />Sally Swanson Architects, Inc.
<br />I-- - -- - -
<br />INsuRERc:Atlantic Specialty Insurance Co 27154
<br />220 Sansome Street, Suite 1100
<br />San Francisco, CA 94104
<br />INSURER D:
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRO-
<br />JECT FLOC
<br />GENERAL AGGREGATE !s2, 00,000
<br />INSURER E:
<br />$
<br />COMBINEDSINGLE LIMIT
<br />EB Accident 1,000,000
<br />INSURER F
<br />COVERAGES CERTIFICATE 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 CONTRACTOR 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSRADDL
<br />LTR
<br />TYPE OF INSURANCE -
<br />INSR
<br />BUBR
<br />WVO
<br />POLICY NUMBER
<br />POLICY EFF POLICYy EXP
<br />(MMIDD/YYV MMIDDIYYYV
<br />__. _ LIMITS
<br />EApCryIHp�OECCTURqRENCE $1,000000
<br />PREMIRESOEe oicuoence $1,000.000
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />—_ -
<br />57SBWBHO903
<br />11/15/2015 11/15/2016
<br />MED EXP (Any one arson, $10,000
<br />PERSONAL &ADV INJURY S1,000,OOO
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRO-
<br />JECT FLOC
<br />GENERAL AGGREGATE !s2, 00,000
<br />PRODUCTS - COMPIOP AGO s2,000,000
<br />$
<br />COMBINEDSINGLE LIMIT
<br />EB Accident 1,000,000
<br />OTHER,
<br />A
<br />AUTOMOBILEUABILRY
<br />57UEGZC8109
<br />11/15/201511/15/201
<br />X
<br />. ANY AUTO
<br />BODILY INJURY (Par person) $
<br />X!,HIREDAUTOS
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON -OWNED
<br />X AUTOS
<br />BODILY INJURY Per ecridenl $
<br />( )•
<br />PROPE idem? AGE -
<br />Peraccitlenl $
<br />$
<br />A
<br />)(1UMBRELLALIAB
<br />X
<br />OCCUR
<br />57SBWBHO903 -
<br />1/15/201511/151201
<br />EACH OCCURRENCE
<br />$2,000.OO0
<br />1, EXCESS LIAR
<br />CLAIMS MADE
<br />AGGREGATE _
<br />_
<br />$2,000000 _
<br />BED RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS' LIABILITY
<br />ANYPROPRIETORIPARTNEWEXECUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED? a
<br />NIA
<br />57WEGGD6783
<br />5/08/2016 05/08/201
<br />X PER ORM -
<br />E.L. EACH ACCIDENT
<br />------
<br />81,000000
<br />(Mandatory In NH)
<br />II yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />_ _
<br />5/03/2016 05/03/201
<br />E.L.D ASE - EA EMPLOYEE
<br />$1.000,000
<br />EL DISEASE -POLICY LIMIT $1,0.00LOOg
<br />$2,000,000 per Claim
<br />C
<br />Professional
<br />DPL542716
<br />Liability
<br />$2,000,000 Ar l Aggr.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Rwmn.ft Schedule, may be attached if more space Ie required)
<br />General Liability Policy excludes claims arising out of the performance of professional services.
<br />Project Name/Number: Access Compliance survey & Database Tracking - Santa Ana Transportation Center
<br />(SARTC)/ #16010.00.00
<br />City of Santa Ana, Its officers, agents, volunteers, and employees are named as Additional Insured as
<br />respects General Liability coverage. Should any of the above described policies be cancelled before the
<br />expiration date thereof, the issuing Insurer will mail 30 days written notice to the Certificate Holder.
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />P.O. Box 1986
<br />Santa Ana, CA 82702
<br />IN MWIATW:I11 iE
<br />ACORD 25 (2014/01) 1 of 1
<br />#$1708615/M1680449
<br />EUNICE HEREDIA (PG /OF
<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 />AUTHORIZED REPRESENTATIVE
<br />(919BB-2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />OTMP1
<br />
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