Laserfiche WebLink
'fib Rb® CERTIFICATE OF LIABILITY INSURANCE <br />DTE (MM) <br />ol� <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(les) 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 />CONTACT Tina Cowie <br />NAME: <br />PHCNEo t, (714)731-7700 AIC No: (714)731-7750 <br />Cornerstone Specialty Insurance Services, Inc. <br />EMAIL <br />ADDRESS: tina@cornerstonespecialty.com <br />14252 Culver Drive, A299 <br />INSURERS AFFORDING COVERAGE NAIC# <br />INSURER A:Travel are Property Casualty CO 25674 <br />Irvine CA 92604 <br />INSURED <br />INSURER s:Travelers Casualty & Surety Co. of 19046 <br />INSURERC: <br />BAYER CONSULTANTS, INC. <br />INSURER D: <br />4067 Hardwick St. <br />INSURER E <br />PNB 250 <br />1 INSURER F: <br />Lakewood CA 90712 <br />COVERAGES CERTIFICATE NUMBER:16/17/18 COVERAGES 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 CONTRACT OR 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 />ILTR <br />TYPE OF INSURANCE <br />Santa Ana, CA 92701 <br />BR <br />POLICY NUMBER <br />POLICY EFF <br />MWDDIYYYY <br />POLICY EXP <br />MMIDDNYYY1 <br />LIMITS <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ 11000,000 <br />A <br />CLAIMS -MADE X❑ OCCUR <br />DAM E T RE TE 1,000,000 <br />PREMISES Ea occurrence $ <br />MED EXP (Any one person) $ 5,000 <br />X ADDTL INSURED/PRIMARY <br />X <br />6130-2J009914-17 <br />6/13/2017 <br />6/13/2018 <br />X BLNKT WVR OF SUBRO <br />PERSONAL A ADV INJURY S 1,000,000 <br />PER FORM # COD3810915 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $ 2,000,000 <br />AS REQUIRED BY WRITTEN <br />POLICY�JECT FLOC <br />CONTRACT <br />PRODUCTS - COMP/OP AGO $ 2,000,000 <br />$ <br />OTHER: <br />CONTRACTUAL LIAB INCLD <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT $ INCLUDED <br />Ee earldom[ <br />BODILY INJURY (Par person) $ <br />A <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />680-2J009914-17 <br />6/13/2017 <br />6/13/2018 <br />BODILY INJURY (Per accident) $ <br />PROPERTY DAMAGE $ <br />Per accident <br />X HIRED AUTOS X NON -OWNED <br />AUTOS <br />X UMBRELLA LIAB <br />4 <br />X <br />OCCUR <br />EACH OCCURRENCE $ 2,000,000 <br />AGGREGATE $ 2,000,000 <br />A <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X I RETENTION$ D <br />1 1 $ <br />CUP-6536YG35-17 <br />6/13/2017 <br />6/13/2018 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNER/EXECUTIVE ❑ <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />PER 01 <br />STATUTE ER <br />E,L, EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYE $ <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $ <br />B <br />Professional Liability <br />106639088 <br />12/1/2016 <br />12/1/2017 <br />Each Claim $2,000,000 <br />Claims Made <br />Annual Aggregate $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is resulted) <br />The City of Santa Ana, it's officers, employees, agents, and representative are Additional Insured for <br />General Liability but only if recfuired by written contract with the Named Insured prior to an occurrence <br />and as per attached endorsement. Coverage is subject to all policy terms and conditions. *30 days notice <br />of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability <br />coverage, the aggregate limit is the total insurance available for all covered claims reported within the <br />policy period. <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2014/01) <br />INS025 (201401) <br />© 1988.2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City Of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />Tina Cowie/SGL <br />ACORD 25 (2014/01) <br />INS025 (201401) <br />© 1988.2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />