|
Client#: 388
<br />SALLYSWANI
<br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE=01
<br />D/YYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />6
<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 policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the 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 endorsement(s).
<br />PRODUCER
<br />NAME: ONTAC Angela N. Borg
<br />Dealey, Renton &Associates
<br />AHCNNo, Ext): 510 465-3090 A c No); 510 452-2193
<br />P. 0. Box 12675
<br />E-MAIL g@deale y
<br />ADDRESS: aborg@dealeyrenton.com
<br />Oakland, CA 94604-2675
<br />11/15/2017
<br />510 465-3090
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURER A: Sentinel Insurance Co. LTD 11000
<br />CLAIMS -MADE 51OCCUR
<br />INSURED
<br />INSURER B: Hartford Ins. Co of Midwest 37478
<br />Sally Swanson Architects, Inc.
<br />INSURER C: Atlantic Specialty Insurance CID 27154
<br />220 Sansome Street, Suite 1100
<br />PREMISES. occu D nce
<br />San Francisco, CA 94104
<br />INSURER D :
<br />$10,000
<br />INSURER E
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD/YYYY
<br />POLICY EXP
<br />MMIDD/YYYY
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />57SBWBHO903
<br />11/15/2016
<br />11/15/2017
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS -MADE 51OCCUR
<br />PREMISES. occu D nce
<br />$1,000,000
<br />MED EXP (Any one person)
<br />$10,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRO-
<br />POLICY T JECT T LOC
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />PRODUCTS - COMPIOP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />57UEGZC8109
<br />11/15/2016
<br />11/15/201
<br />CMINED
<br />EaaccidentSINGLELIMIT)
<br />1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X
<br />ANY AUTO
<br />X
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON -OWNED
<br />HIRED AUTOS Ix AUTOS
<br />BODILY INJURY (Per accident)
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MA iii
<br />VIEW
<br />_
<br />EC
<br />BY: _._. ._._ EU�t
<br />CE H ¢�i. Dt
<br />, (P' g I
<br />) REGATE
<br />$
<br />DED RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.
<br />OFFICER/MEMBER EXCLUDED? �
<br />N / A
<br />57WEGGD6783
<br />5/08/2016
<br />05/08/2017
<br />X PER OTH-
<br />ER
<br />EACH ACCIDENT
<br />$1,000,000
<br />- -- -
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000 000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,090,000
<br />C
<br />Professional
<br />DPL542716
<br />5/03/2016
<br />05/03/2017
<br />$2,000,000 per Claim
<br />Liability
<br />$2,000,000 Annl Aggr.
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is 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 1988
<br />Santa Ana, CA 92702-1988
<br />ACORD 25 (2014/01) 1 Of 1
<br />#S1870700/M1870682
<br />uini
<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 />©1988-2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />AZM
<br />
|