|
ACC>RhP CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDIYYYY)
<br />✓` 1 8/7/2017
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />TYPE OF INSURANCE
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />N1VD
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />MMIDDIYVVY
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />LIMITS
<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 />GENERAL LIABILITY
<br />Certificate holder in lieu of such endorsements).
<br />PRODUCER
<br />Dealey, Renton & Associates
<br />DRA License 0020739
<br />P. 0. Box 10550
<br />COC
<br />NAME:
<br />_
<br />PHONE FA%
<br />e gi,714-427- AlcNe: 4-427-6818
<br />E-MAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAICAt
<br />Santa Ana CA 92711-0550
<br />INSURER A:Trayelej$ Prooe Ca al Co of A
<br />DAMAGE TO RENT U
<br />PREMISES Eaoccunce $1,000,000
<br />rre
<br />_
<br />INSURED
<br />INSURERB:Travelers Casualty & Surety Co Ame31194
<br />INSURER C:
<br />FCS International, Inc.
<br />250 Commerce, Suite 250
<br />Irvine CA 92602
<br />INSURER O:
<br />(PERSONAL&ADV INJURY $1,000,000__
<br />X Contractual
<br />INSURER E:
<br />INSURER F:
<br />Liability
<br />GENERAL AGGREGATE $2, 000,000
<br />COVERAGES CERTIFICATE NUMBER: 1319734399 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 />(LTR
<br />TYPE OF INSURANCE
<br />(NSR
<br />N1VD
<br />POLICY NUMBER
<br />MMIDDIYVVY
<br />MMUODVM'YPY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />Y
<br />66051-959493
<br />1/1/2017
<br />1/1/2018
<br />EACH OCCURRENCE $1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />DAMAGE TO RENT U
<br />PREMISES Eaoccunce $1,000,000
<br />rre
<br />_
<br />CLAIMS -MADE X❑ OCCUR
<br />MED EXP one person) $10,000
<br />(PERSONAL&ADV INJURY $1,000,000__
<br />X Contractual
<br />Liability
<br />GENERAL AGGREGATE $2, 000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER'.
<br />_1LOC
<br />PRODUCTS-COMP/OP AGG $2,000,000
<br />Deductible $None
<br />POLICY X IRI-
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />BA6078L716
<br />1/1/2017
<br />1/1/2018
<br />Ea accident)___.__-__ $1,000,000
<br />BODILY INJURY (Porpereon) 8
<br />X
<br />ANY AUTO
<br />_
<br />X
<br />ALL OWNED SCHEDULED
<br />AUTOS(
<br />NON-OWNED
<br />AUTOS PX[Norne
<br />BODI LY INJURY Per accident $
<br />)
<br />PROPERTY DAMAGE$HIREDAUTOSAUTOS PeraccdentDeductible
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE $
<br />(AGGREGATE $
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />ANDEMPLOVERS'LIABILITY YIN
<br />UB1427T762
<br />1/1/2017
<br />1/1/2018
<br />X WCSTATU- OTH-
<br />TORY LIMITS E
<br />E.L. EACHACCIDENT $1,000,000
<br />ANY PROPRIETOMPARTNEMEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />---
<br />ELME_:EMPLOYE $1,000,000
<br />(MandatorylnNH)
<br />If yes, descnibeunder
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT I $1,000,000
<br />B
<br />Professional Liability
<br />Claims Made
<br />106035068
<br />1/1/2017
<br />1/1/2018
<br />i
<br />Per Claim $2,000,000
<br />Annual Aggr. $2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />General Liability policy excludes claims arising out of the performance of professional services.
<br />Re: All Operations of the Named insured - City of Santa Ana, its officers, employees, agents, volunteers, and representatives are named as
<br />additional insureds as respects general liability for claims arising from the operations of the named insured as required per written contract or
<br />agreement. SEE CANCELLATION SECTION of Certificate for 30 Day Notice of Cancellation.
<br />CERTIFCATE HOLDER CANCELLATION 30 Day NOC/10 Day for NonPay of Prem
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) 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 (M-30)
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />P.O. Box 1988
<br />Santa Ana CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />m .
<br />r
<br />�rru�
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
|