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RINCCON-01 PRISS
<br />ouzo CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDD/ V }
<br />,—� n1 roRrvnl G
<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 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 endorsoment(s).
<br />PRODUCER License #10E67768 EA
<br />-ccT ,Elizabeth Leach
<br />Le ends Environmental Ins. Services
<br />AtCno,Ext_, 297-553752011 (AA
<br />130Vanfis ic,No):(949)297-5960
<br />INSURED
<br />CA 92656
<br />Rincon Consultants, Inc.
<br />210 N Ashwood Ave
<br />Ventura, CA 93033
<br />_ INSURER($(AFFGRDING COVERAGE ___, NAIC4
<br />A;Crum & Forster Specialty Insurance_Company�44520
<br />B Trumbull Insurance Company _. _ 27120 _
<br />C:StarStone National Insurance Comfy 25496_
<br />INSURER D:
<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
<br />OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO
<br />WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL
<br />THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />_- L
<br />ADODL 9UBp
<br />IA TYPE OF INSURANCE POLICY NUMBER
<br />POLICY EFF POLICY E%P LIMITS
<br />-
<br />COMMERCIAL GENERAL LIABILITY
<br />EACHEACH O $
<br />3,000,000
<br />CLAIMS MADE X OCCUR EPK125280
<br />12/17/2018', 12/17/2020 DAMAGES(Eaoc renaa)__.
<br />- -$ -
<br />PERSONAIBACF NJURY
<br />10,000
<br />3,000,000,,
<br />_
<br />GEHL AGGREGATE pL�INT I' APPLIES PER:
<br />POLICY �� JEC i_,_ LOC
<br />_$
<br />i GENERAL AGGREGATE $
<br />PRODUCTS - COMP/OP AGG $
<br />4,000,000
<br />4,644,400'.
<br />OTHER' l
<br />,Deductible $
<br />5Q000
<br />B AUTOMOBILE LIABILITY X
<br />X ANY Auio 72UUNPT4318
<br />ANY AU
<br />COMBINED SINGLE I J M I 1
<br />(Ea eWd.tL $
<br />12/17/2010 BODILY INJURY (Per Garsou) $
<br />12/1712018iII
<br />1,000,000
<br />EGHtDDLED I
<br />AUTOS ONLY AUTOS
<br />GORILY INJURY Per accMeot)_$
<br />_.
<br />LX. VRE S ONLY X I AUUT03 O
<br />4 PROPERTY DAMAGE
<br />Per a StleFltt £
<br />OCCUR
<br />EACH�OCCURRENCE
<br />$ O,000,UUU
<br />EXCESS LABIAB _X
<br />X _ _
<br />EFX111982
<br />12/17/2018'
<br />_EACH
<br />12/17/2019 AGGREGATE
<br />$ 5,000,000
<br />DED I X R ETEN ( ION$ 10,000:
<br />$
<br />C WORKERS COMPENSATION
<br />AND EMPLOYERS LIABILITY (
<br />X STATUTE _ERH
<br />f
<br />YtN T
<br />ANY PROPRIMEER}EXCLUDRfE%ECllTiVE�
<br />T10190329
<br />42t01t2019
<br />0270112420 CL EACH ACOICEN1
<br />1,000,000
<br />;S_
<br />gg,,FIGERtMEM i"i,NtA
<br />1,000,000
<br />NH)EXClUDEO?
<br />IManddf kn NH}
<br />E.L. DISEASE -EA_EMPtGYEE_S
<br />11006,000
<br />DESCRIPTION
<br />DESCRIPTION OF OPERATIONS below
<br />Iz.L. DISEASE -POLICY LIMIT
<br />5
<br />q Professional Liab I
<br />EPK125280
<br />12/17/2018
<br />12/17/2020 Per Claim
<br />11000,000
<br />A (Professional Liab
<br />EPK125280
<br />12117/2018
<br />12/17/2020 (Aggregate
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS! LOCATIONS t VEHICLES jACORD lei, Atldiflm,zi Remnrka Schetlu3a, may he attachdtl ft mere space is requlr¢tlj
<br />''..
<br />lonai Liability is written on a Claims Made basis. When required by written contract, the General Liability and Pollution Liability Limits are on a Per
<br />iasis while dedicated; the Professional Liability is on a Per Policy basis. Professional Liability Deductible $50,000 Each Claim.
<br />of Santa Ana its officers, employees, agents, volunteers and representatives are Included as additional Insureds for General Liability and Auto
<br />with respect to work performed for them by the Named Insured as required by written contract, per Blanket Additional Insured endorsement EN0147-
<br />10320-OQ9y OL12yfl" f� .Q:LR0.D Lilpity Coverage Is Primary and Non -Contributory as required by written contract, per endorsement EN0147
<br />(ACHE di r_#VM_1i tz tYt 1V/ {L.� i7..J{ it�7 Y
<br />�ICATE OL,DiR CANCELLATION
<br />_ 1at.-.Ae�c, <flraJ, g
<br />OF
<br />t� 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 />City of Santa Ana - Public Works Agency AUTHORIZED REPRESENTATIVE
<br />Attn: Water Resources Department �t
<br />20 Civic Center Plaza, M-21, P.O. Box 1988
<br />ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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