RINCON CONSULTANTS, INC. 5 -2014

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Em AR o® CERTIFICATE ®F LIABILITY INSURANCE D1 /z6�2o 6Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Pam Ayerle AINS 6737 : AIC No: (805)585 -6837 poSx 5tolmanandwiker. Tolman & Wiker Insurance Services LLC #OE52073 196 S. Fir Street P ayerle com PO Box 1388 INSURERIS) AFFORDING COVERAGE NAICIf INSURER A:Travelers Prop Cas CO of Amer 025674 Ventura CA 93002 -1388 INSURED INSURERB:TOr'us National Ins CO 25496 INSURER C : INSURERD: Rincon Consultants Inc. INSURERE: $ 180 N. Ashwood Ave. INSURER F: Ventura CA 93003 COVERAGES CERTIFICATE NUMBER:15 /16 AU /WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IITR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS David Shore /PAMELA COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMSMADE OCCUR DAMA ET RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY [] PECT RO- ❑ LOC J PRODUCTS - COMPIOP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 8 BODILY INJURY (Per person) $ A ANYAUTO ALL AUTOS OWNED SCHEDULED BA- 5G112538- 15 -DAG 12/17/2015 12/17/2016 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOMPARTNER /EXECUTIVE OFFICERIMEMBER EXCLUDED? F-1 (Mandatory In NH) NIA T10160329 2/1/2016 2/1/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (ACORD 101, Addltl one] Remarks Schedule, may be attached if more space Is required) AUTO: The City, its officers, employees, agents, volunteers and representatives are Additional Insured as respects to operations of the Named Insured per form CAT4740215. WC: A Waiver of Subrogation is added in favor of the Certificate Holder per form WC040306. Endorsements apply only as required by written contract during the policy term. npxv t C�.I T_n CERTIFICATE HOLDER CANCELLATION sharon @wcspermits.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Planning & Building Agency ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 David Shore /PAMELA ACORD 25 (2014101) INS025 (201401) ©1988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD