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Last modified
4/13/2021 3:08:47 PM
Creation date
7/5/2018 11:16:18 AM
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Contracts
Company Name
MVR CONSULTING
Contract #
A-2018-150
Agency
PUBLIC WORKS
Council Approval Date
6/5/2018
Expiration Date
6/4/2020
Insurance Exp Date
2/22/2022
Destruction Year
2025
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MVRCONS-02 <br />GFIETSCH <br />,4coR®' CERTIFICATE OF LIABILITY INSURANCE <br />� <br />DATE/ <br />TYPE OF INSURANCE <br />061111/20181/2018 <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER License # 26480 CONTACT <br />NAME: <br />HUB International Mountain States Limited 1 FAX Nep(866) 898.4905 <br />PHONE Est): (208) 433-1000 <br />2600 Rose Hill, Suite 101 : <br />PO Box 58151 ..- <br />Boise, ID 83705 <br />INSURER(S) AFFORDING COVERAGE I NAIC M <br />INSURER A: Sentinel Insurance Company, Ltd. 111000 <br />INSURED INSURER B: <br />MVR Consultingi INSURER C: <br />P.O. Box 236 INSURER D: <br />Calimesa, CA 92320 <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 />TYPE OF INSURANCE <br />"NSD <br />WVD <br />POLICY NUMBER <br />POpICYY <br />y0Mi`6`U`s%P <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITYEACH <br />CLAIMS -MADE ® OCCUR <br />Hired & Non -Owned <br />X <br />34SBMIJ6649 <br />f 0212212018 <br />02122/2018$ <br />j <br />02/22/2019 <br />OCCURRENCE $ 2,000,000 <br />DAMAGES RENTED11000'000 <br />X <br />X <br />GEN'L <br />X <br />10,000 MED EXP (Any one arson $ <br />Auto Liability <br />INJURY $ 2,000,000 <br />AGGREGATE LI MIT APPLIES PER: <br />POLICY LOC! <br />OTHER'. <br />,PERSONAL&ADV _ <br />GENERAL AGGREGATE $ 4'000'000 <br />_ <br />PRODUCTS -COMPIOPAGG $ 4,000,000 <br />$ <br />AUTOMOBILE <br />_ <br />.._. <br />LIABILITY <br />ANY AUTO _ _ <br />OWNED SCHEDULED <br />AUTOS ONLY __ AUOTNOpSyyNEo <br />AUT OE ONLY __.. AUTOS ONLY <br />I,. <br />!, <br />COMBINED SINGLE LIMIT <br />Ea accident <br />BODILY INJURY Per person)$ <br />_ <br />BODILY INJURY Per eccldent <br />Pe�eccRdent AMAGE -"-" <br />UMBRELLA LIAB <br />EXCESS UAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE $ <br />AGGREGATE <br />DED RETENTION$ <br />$ <br />WORKERS <br />ND EMPLOYERS LIABIILOITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE"'"' <br />QpFILEaIMEMWp EXCLUDED? <br />(Mantlatory In NH) — <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />$TARTUTE _. 0TH- <br />LR ____ <br />E1. AOCI DENT $ <br />_EACH <br />E.LDISEASE-EAEMPLOYEE $ <br />E.L. DISEASE -POLICY LIMIT $ <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES UNCORD 101, Additional Remarks Schedule, may be aaached If more space is required) <br />The City of Santa Ana, it's officers, employees, agents and representative are Additional Insureds with respects to General Liability when required by written <br />contract perform SS0008. <br />City of Santa Ana <br />Attn: Purchasing Department <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <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 />ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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