CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMMMYYYY)
<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 endorsementfsl.
<br />PRODUCER
<br />Dealey, Renton & Associates
<br />Lic. #0020739
<br />600 Anton Blvd., Suite 100
<br />Costa Mesa CA 92626
<br />INsuaeo
<br />VCA Consultants, Inc.
<br />(See Desc. of Operations for Full Named Insured)
<br />1845 W, Orangewood Ave, Suite 200
<br />Orange CA 92868
<br />— —
<br />' INC, Net 714-427.6818
<br />COVERAGES CERTIFICATE NUMBER- 12474B77R0 - Rc1NCI0M 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�— TYPE OF INSURANCE ADOL SUBR' POLICY EFF POLICYEXP -
<br />INS lilwol POLICYNUMBER tMWDD1YYYY I (MMIDDIVY"n I LIMITS
<br />A
<br />rX
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMUSID OCCUR
<br />CoOVaduel Lkb
<br />Y I Y
<br />6802,1614026
<br />7/112019 7/1/2020
<br />EACH OCCURRENCE
<br />S1,000,000
<br />PREMISES Ea occvrtm�
<br />31,000,D00
<br />X
<br />'I MED EXP IAn one person)
<br />$10,000
<br />PERSONAL&ADVINJURY
<br />S1,00g000
<br />AGGREGATE LIMIT APPLIES PER
<br />x.PERT LOD
<br />GENERALAGGREGATE
<br />_
<br />S2,000,000
<br />G EIN'L
<br />j
<br />PRODUCTS-COMPIOPAGG
<br />_
<br />52,ODO,000
<br />_.
<br />&
<br />I�POLICY
<br />OTHER:
<br />A AUTOMOBILEUASIUTY
<br />X ANY AUTO
<br />Y Y BA6E503102
<br />7/1/2019 V1/2020
<br />COMBINED SINGLE LIMIT
<br />Ea accitlent
<br />51,DOO,000
<br />BODILY INJURY (Per person)
<br />S
<br />OWNED 'SCHEDULED
<br />AUTOS ONLY I I AUTOS
<br />-
<br />BODILY INJURY (Per accident)
<br />S
<br />X HIRED AU rOS ONLY ILf AUTOS ONLNON-CIVNEY
<br />AU
<br />PROPERTYEe DAMAGE
<br />-
<br />$
<br />A
<br />X
<br />UMSRELLALIAB X OCCUR I T CUPSE569601
<br />7112019 7/112020
<br />EACHOCCURRENCE
<br />$5,000,000
<br />Excess UA6 �i I CLAIMS-MAOE
<br />-gGGREGATE
<br />$s,DDD.DOD
<br />BED X ;RETENTIONS
<br />g
<br />A
<br />WORKERS COMPENSATION Y US71<022575
<br />AND EMPLOYERS' UABILT Y YIN
<br />ANYPROPRIETOWPARTNER/EXECOTIVE NIA
<br />OFFICERIMEMBER EXCLUDED?
<br />7/112019 7H2O20
<br />X_ STATUTE _ OEPI+_
<br />-
<br />_—
<br />E.L. EACH ACCIDENT
<br />51,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />_.
<br />S1,000,000
<br />(Mandatory In NH)
<br />Il unOF
<br />DISEASE -POLICY LIMIT
<br />$1,000,000
<br />DESCyea,daRIPTIONsulbe OderPERATIONS pan.EL
<br />B Prolessi0nel Oebiliry MKLV7PL0003741
<br />Claims Made
<br />7/112019 7/1/2020 Per Claim
<br />Annual Aggregate
<br />S2,000,000
<br />$4,000,000
<br />DESCMPTIONOFOPERATIONSILOCATIONSIVEHICLES (ACORD/01, Additional Reserve schedule. may be attached if more apace le required)
<br />Named Insured Includes: BOB VCA Structural. dba VCA Consultants; Van Dorpe Chou Associates. Inc.: The Code Group, Inc.;
<br />dba VCA Green; dba VCA Code; dba VCA Code Group.
<br />Umbrella policy Is a follow -form to underlying General Liability/Auto Liability/Employers Liability
<br />Re: Contract Staling, Plan Check, and Sustainability Services
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as Additional Insured as respects General & Auto Liability as required per written
<br />contract or agreement. General Liability is Primary/Non-Contributory per policy form warding. Insurance coverage Includes waiver of subrogation per the
<br />attached endorsements.
<br />See Attached...
<br />City of Santa Ana
<br />Risk Management Di'
<br />20 Civic Center PlazE
<br />Santa Ana CA 92702
<br />25 2019
<br />M. LAMBERT
<br />i-rem
<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 />01988.2015 ACORD
<br />reserved.
<br />ACORO 25 (2016103)
<br />fhe ACORD name and logo are registered marks of ACORD
<br />
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