Laserfiche WebLink
Client#: 25320 <br />KIMLHORN <br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMmOnYYY) <br />4/17/2017 <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 />Greyling Ins. Brokerage/EPIC <br />3780 Mansell Road, Suite 370 <br />Alpharetta, GA 30022 <br />CONTACT Jerry Noyola <br />NAME:PHONE <br />770-552-4225 866-550-4082 <br />Ext : AIC, No <br />E-MAIL <br />ADDRESS: )erry.noyola@greyling.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURER A: National Union Fire Ins. Co. <br />19445 <br />INSURED Kimley-Horn and Associates, Inc. <br />421 Fayetteville Street, Suite 600 <br />Raleigh, NC 27601 <br />INSURER B: Aspen American Insurance Compan <br />43460 <br />INSURER c: New Hampshire ins. Co. <br />23841 <br />INSURER D: Lloyds of London <br />085202 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 17-18 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 />LTFR <br />TYPE OF INSURANCE <br />ADDLSUSR <br />INSR <br />MOP <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD/YYY <br />POLICY EXP <br />MMIDDIYY <br />UNITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />5268169 <br />4/01/2017 <br />04/01/201 <br />$1 000000 <br />pEpACH�OECCURRENCE <br />PREMISES E..¢Turrence <br />$500000 <br />X <br />MED EXP (Any one penam) <br />$25000 <br />Contractual Llab. <br />PERSONAL &ADV INJURY <br />$1 000000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY 51 JECOT LOC <br />GENERAL AGGREGATE <br />$2,000,000 <br />PRODUCTS - COMP/OP AGG <br />$2,000,000 <br />$ <br />_ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />4489663 <br />4/01/2017 <br />04/01/201 <br />EOaeBIIEEDtSINGLELIMIT <br />1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS X NOIED <br />AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />X <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />B <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />CX005FT17 <br />4/01/2017 <br />04/01/2018 <br />EACH OCCURRENCE <br />$5000000 <br />AGGREGATE <br />$5 00O 000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />DEO X RETENTION$0 <br />$ <br />C <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILnY YIN <br />ANY PROPRIETOMPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />N/A <br />015893685 AOS <br />( ) <br />015893686 (CA) <br />4/01/2017 <br />4/01/2017 <br />04/01/201 <br />04/0112018 <br />X PER OTH- <br />E.L. EACH ACCIDENT <br />$1 00O 000 <br />E.L. DISEASE EA EMPLOYEE <br />$1 000000 <br />It yea. describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE POLICY LIMIT <br />$1000000 <br />D <br />Professiona1Liab <br />P070831700 <br />4/01/2017 <br />04/01/201 <br />Per Claim $2,000,000 <br />1 <br />Aggregate $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, AddlUonal Remarks Schedule, may be attached it more space Is required) <br />Re: On -Call Agreements A-2015-171, A-2009-212 & A-2016-344. The City of Santa Ana, its officers, <br />employees, agents & representatives are named as Additional Insureds with respects to General Liability <br />where required by written contract. The above referenced liability policies with the exception of <br />professional liability are primary & non-contributory where required by written contract. Separation of <br />Insureds applies to the General Liability Policy. Umbrella Follows Form with res ects to General <br />(See Attached Descriptions) REVIEWED BY: EUNICE HEREDIA (PG )OF ) <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana, CA 92701-0000 AUTHORIZED REPRESENTATIVE <br />@ 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) 1 Of 2 The ACORD name and logo are registered marks of ACORD <br />#S768933/M695961 JNOY1 <br />