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BLACK O'DOWD AND ASSOCIATES, INC.
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Last modified
9/27/2021 4:34:08 PM
Creation date
9/27/2021 4:32:01 PM
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Contracts
Company Name
BLACK O'DOWD AND ASSOCIATES, INC.
Contract #
A-2021-177-06
Agency
Public Works
Council Approval Date
9/7/2021
Insurance Exp Date
11/20/2021
Destruction Year
2028
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Francine R. <br />Villareal <br />ACCM CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDD)YYYY) <br />11/20/2020 <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 />CONTACT $ue LUSIC <br />NAME: <br />Cornerstone Specially Insurance Services, Inc. <br />PHONE (714) 731-7700 FAX (714) 731-7750 <br />A/C No Ezt: AIC, No: <br />14252 Culver Drive, A299 <br />EMAIL sue@comerstones eclat com <br />ADDREBS: P ry' <br />INSURER(S) AFFORDING COVERAGE <br />NAIC II <br />Irvine CA 92604 <br />INSURERA: RU Insurance Company <br />13056 <br />INSURED <br />INSURER B: Aspen American Insurance Company <br />43460 <br />BOA ARCHITECTURE <br />INSURER C <br />1511 Cola Avenue <br />INSURER D: <br />INSURER E <br />Long Beach CA 90813 <br />INSURERF: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DDNWY <br />POLICY EXP <br />MMIDDNYYY <br />LIMITS <br />X <br />COMMERCIAL GENERALLIABILITY <br />DLAIMS-MADE 7XI OCCUR <br />EACH OCCURRENCE <br />IS 2.000,000 <br />PREMISES Ea occumence <br />$ 1,000,000 <br />X <br />MED EXP (Anyone person) <br />$ 10,000 <br />ADDT'L INSURED / PRIMARY <br />X <br />BLNKTWVROFSUBRO <br />PERSONAL B ADV INJURY <br />$ INCLUDED <br />A <br />Y <br />PSB0007999 <br />11/20/2020 <br />11/20/2021 <br />GENLAGGREGATE LIMITAPPLIES PER: <br />POLICY N PRO- <br />JECT LOC <br />GENERALAGGREGATE <br />$ 4,000,000 <br />PRODUCTS - COMP/OPAGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />S 2,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />PS80007999 <br />11/20/2020 <br />11/20/2021 <br />BODILY INJURY Peraccident <br />( ) <br />$ <br />HIRED v NON -OWNED <br />AUTOS ONLY /� AUTOS ONLY <br />X <br />PROPERTY DAMAGE <br />Peraccident <br />$ <br />$ <br />X <br />UMBRELLALIAS <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />A <br />EXCESS UAB <br />CLAIMs-hMOE <br />PSE0003983 <br />11/20/2020 <br />11/20/2021 <br />AGGREGATE <br />$ 1,000,000 <br />DED <br />I I RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITYYIN <br />ANY PROPRIETORIPARTNEMEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? 171 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />PSW0004454 <br />11/20/2020 <br />11/20/2021 <br />PER OTH- <br />X STATUTE ER <br />E.L. EACH ACCIDENT <br />S 1.000.000 <br />E.L. DISEASE - EA EMPLOYEE <br />S 1.000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />PROFESSIONAL LIABILITY <br />EACH CLAIM <br />$2.000,000 <br />B <br />Claims Made <br />F. <br />AAAE100264-02 <br />11/20/2020 <br />11/20/2021 <br />ANNUALAGGREGATE <br />$2.000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: RFP 20-040 Space Planning and Architectural Services <br />Certificate Holder is Additional Insured for General Liability but only if required by written contract with the Named Insured prior to an occurrence and as per <br />attached endorsement. Coverage is subject to all policy terms and conditions. 30 days Notice of Cancellation "Except 10 days Notice of Cancellation for <br />non-payment of premium. For Professional Liability coverage, the aggregate limit is the total insurance available for all covered claims reported within the <br />policy period. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza, 4th FI. <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 WdrMnmgrn¢nElXviaiwL <br />,v% (�vIEViED6 MPROv®BY: <br />©1988-2015 ACORD <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD' Risk Management Analyst <br />
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