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Francine R.
<br />Villareal
<br />GILL&PA-01 MCGRAWM
<br />.44cCERTIFICATE OF LIABILITY INSURANCE
<br />DATE
<br />��
<br />11/16/20
<br />1/76/200
<br />20
<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 License # OE67768 CONTACT Erica Wilson
<br />NAME:
<br />IOA Insurance Services PHONE
<br />IAIC, No, E:q: (858) 754-0063 50233 jac, No :(619) 574-6288
<br />4370 La Jolla Village Drive
<br />Suite 600 ADDDRESS, Erica.Wilson@ioausa.com
<br />San Diego, CA 92122
<br />INSURERS AFFORDING COVERAGE NAIC#
<br />INSURER A: RLI Insurance Company 13066
<br />INSURED
<br />INSURER B:HudsonInsurance Company
<br />26064
<br />INSURER C :
<br />Gillis & Panichapan Architects, Incorporated
<br />INSURERD:
<br />2900 Bristol St. Suite G205
<br />Costa Mesa, CA 92626
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: RFVISION NIIMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO 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 TYPE OF INSURANCE
<br />ADDLSUBR
<br />Man
<br />Wun
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY E%P
<br />p
<br />LIMITS
<br />A X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />PSBOOOII19
<br />91V2020
<br />911/2021
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occunence
<br />1,000,000
<br />$
<br />X Contractual Llab.
<br />X Sev, of Interests
<br />one parson)
<br />MED EXP AUCOMBINEDSINNGLE
<br />$ 10,000
<br />PERSONAL INJURY
<br />$ 2,000,000
<br />AGGREGATE
<br />S 4,000,000
<br />L AGGREGATE LIMIT APPLIES PER:
<br />POLICY X iE� LOG
<br />MOTHER.
<br />S-COMROPAGG
<br />$ 4,000,000
<br />ble
<br />S 0
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />DSINGLE LIMIT
<br />nt
<br />1,000,000
<br />JURY Per arson
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULEDAU�RRTOpDS ONLY AUT{Sw�
<br />PSA0001116
<br />91112020
<br />911/2021
<br />JURY Per ecadera
<br />$
<br />PoracrRrlenYAMAGE
<br />$
<br />AUTE05 ONLY AUTOS ONLB
<br />Comp.: $1,000 X Cull._ $1,000
<br />X
<br />A
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 3,000,000
<br />AGGREGATE
<br />$ 3,000,000
<br />X
<br />E%CESS UAB
<br />CLAIMS -MADE
<br />PSE0001038
<br />9/1/2020
<br />9/1/2021
<br />DED X RETENTION $ D
<br />$
<br />A
<br />AND EMPLOCOMPENSATION
<br />ERS' LIA LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICER/M',MBER EXCLUDED?
<br />(Mandat. rym N.,
<br />If yes, descnbe under
<br />OF OPERATIONS below
<br />NIA
<br />PSW0001177
<br />9/1/2020
<br />9/1/2021
<br />X STATUTE ERH
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000DESCRIPTION
<br />$
<br />B
<br />Prof LiablClms Made
<br />PRB0619110942
<br />11/8/2020 11/812021
<br />Per Claim
<br />4000,000
<br />B
<br />Ded.: $5k Per Claim
<br />PRB0619110942
<br />111812020 1118/2021
<br />Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be abached if more space is required)
<br />Re: All Operations
<br />The City of Santa Ana is Additional Insured with respect to General Liability per the attached endorsement as required by written contract
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions.
<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 />City of Santa Ana AUTHORRED REPRESENTATIVE
<br />Risk Management Division lI _-/ Risk MOuganmtDivislan
<br />20 Civic Center Plaza, 4th Floor `1. `ew"`k-� ,'' REvIEwED&APPROVED BY:
<br />Santa Ana- CA 92702
<br />ACORD 25 (2016/03) ©1988-2015 ACORD C !�:,
<br />The ACORD name and logo are registered marks of ACORD Ruk Management Analyst
<br />
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