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Francine R. o1audm,y�mwr,,,,r„max
<br />mina
<br />Villareal usaor
<br />ACORbr CERTIFICATE OF LIABILITY INSURANCE
<br />llk i
<br />DATE(MMIODNYYY
<br />11/13/2020
<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 endorsement(s).
<br />PRODUCER
<br />Dealey, Renton & Associates
<br />790 E Colorado Blvd., At460
<br />Pasadena CA 91101
<br />CONTACT
<br />Marie Swaney
<br />PHONE FAx
<br />uc N�
<br />ADDRESS, mswaney0dealeyrenton,com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC if
<br />INSURER A: Travelers Property Casualty Company of America
<br />25674
<br />License/P: 0020739
<br />INSURED WESTDES-04
<br />Designs, Inc.
<br />Westgro19520J Jamboree
<br />19520 Jamboree Rd., Suite 100
<br />INSURERS: Travelers Casualty and Surety Co of America
<br />31194
<br />INSURER C: The Travelers IndemnityCompany of Connecticut
<br />25682
<br />wsuRER D : Twin CityFire Insurance Company
<br />29459
<br />Irvine, CA 92612
<br />949 250-0880
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 699595088 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />INSO
<br />MD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD/YYYY
<br />POLICY UP
<br />MMIDDIYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />Y
<br />Y
<br />6806H393952
<br />10/1/2020
<br />10/1/2021
<br />EACH OCCURRENCE
<br />S1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$1,000,000
<br />X
<br />MED UP An ( y one Person)
<br />$10,000
<br />Contractual Liab
<br />I XCU Included
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />X
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY � JECT El PRO- LOC
<br />GENERALAGGREGATE
<br />$2,000.000
<br />GEN'L
<br />PRODUCTS - COMPIOP AGG
<br />$2,000,000
<br />S
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />BA9H218891
<br />10/1/2020
<br />10/1/2021
<br />COMBINED SINGLE LIMIT
<br />Ea accident)
<br />$1,000,000
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Per person)
<br />$
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INIJURY(Peracod.,n)
<br />S
<br />X
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTYOAMAGE
<br />Per accitlentI
<br />$
<br />$
<br />A
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CUP6C746237
<br />10/l/2020
<br />10/1/2021
<br />EACH OCCURRENCE
<br />$1,00o00o
<br />AGGREGATE
<br />$1,000,000
<br />E%CESS LIAR
<br />CLAIMS -MADE
<br />DED X RETENTIONS n
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />Y
<br />57WEGGG2203
<br />10/l/2020
<br />10/1/2021
<br />X STATUTE ERH
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />ANYPROPRIETORIPARTNER/EXECUTIVE
<br />OFFICEMMEMBEREXCLUDED?
<br />NIA
<br />E.L. DISEASE - E,EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L DISEASE -POLICY LIMIT
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />B
<br />Professional Liability
<br />105677979
<br />9/9/2020
<br />9/g/2021
<br />Per Claim
<br />$2.000.000
<br />Annual Aggregate
<br />$2,000.000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Umbrella policy is follow -form to its underlying Policies: General Liability/Auto Liability/Employers Liability.
<br />RE: RFP #20-040, On -Call AS for City's Public Works Agency —
<br />the City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as an additional insured as respects general liability as
<br />required per written contract or agreement. General Liability is Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of
<br />subrogation per the attached endomement(s). CANCELLATION/CHANGE: 30 day notice will be sent to the certificate holder.
<br />CERTIFICATE HOLDER CANCELLATION 30 Dav Notice will be sent to holder
<br />City of Santa Ana, Risk Mgmnt Div.
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana CA 92702
<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 />©1988-2015 ACORD CI
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />RWeM%regernmtDlWtlon
<br />REVIEWED&APPRDVEDBY:
<br />Risk Management Analyst
<br />
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