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DENEEN POWELL ATELIER, INC
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Last modified
5/31/2022 10:41:57 AM
Creation date
12/15/2021 9:56:39 AM
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Contracts
Company Name
DENEEN POWELL ATELIER, INC
Contract #
N-2021-246
Agency
Parks, Recreation, & Community Services
Expiration Date
12/31/2022
Insurance Exp Date
5/1/2023
Destruction Year
2027
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Francine R. cgaal,ygl� LY eandn R. <br />Yllareal <br />Villareal °""M C <br />DENEPOW-01 OWAN <br />CERTIFICATE OF LIABILITY INSURANCE DATE/30f30//2021Y) <br />11021 <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 I gq;; JACT Dana Schwartz <br />574-6288 <br />INSURED <br />CA 92122 <br />Deneen Powell Atelier Inc <br />2305 El Cajon Blvd <br />San Diego, CA 92104 <br />F: <br />COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUER <br />VIVO <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXPLTR <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCUR <br />Cont Liab/Sev of Int <br />X <br />X <br />PSB0002153 <br />5/112021 <br />511/2022 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTED <br />REMISES Eaoccu a ce <br />$ 1,000,000 <br />X <br />MED EXP An one Person) <br />10,000 <br />PERSONAL &ADV INJURY <br />1,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY �X JELQT LOC <br />GENERAL AGGREGATE <br />2,000,000 <br />GENT <br />PRODUCTS-COMP/OP AGO <br />2,000,000 <br />Deductible <br />0 <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />COMBIaFDISINGLE LIMIT <br />$ 1,000,000 <br />BODILY INJURY Per erson <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTO{{S�� <br />X <br />PSB0002153 <br />511/2021 <br />5/112022 <br />Ix <br />BODILY INJURY Per accident <br />$ <br />Fp <br />AUTOS ONLY X AIOfrNOS ON0ICV <br />AMAGE <br />dar e�Rd dent <br />$ <br />A <br />X <br />UMBRELLALIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />PSE0001615 <br />5/1/2021 <br />5/112022 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />AGGREGATE <br />1100000 <br />DEO I X I RETENTION$ 0 <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNER/EXECUTIVE YIN <br />(Mantlalary In NX)EXCLUDED? 1-1 <br />If yes. describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />X <br />PSWOOO1885 <br />5/1/2021 <br />51112022 <br />X PER OTH- <br />TUI'EER <br />E.L. EACH ACCIDENT <br />1,000,000 <br />$ <br />EL DISEASE - EA EMPLOYE <br />1,000,000 <br />$ <br />E.L DISEASE -POLICY LIMIT <br />S 1,000,000 <br />B <br />Professional Liab. <br />AEXNYABMQTA003 <br />5/112021 <br />51112022 <br />Per Claim <br />2,000,000 <br />B <br />Ded.: $5K Per Claim <br />AEXNYABMQTA003 <br />5/112021 <br />511/2022 <br />Aggregate <br />4,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached K more space is required) <br />Re: Santa Ana Zoo Pathways Project <br />City of Santa Ana, officers, agents, employees, and volunteers is Additional Insured with respect to General/Hired & Non -Owned Auto Liability per the <br />attached endorsement as required by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to General Liability and <br />Workers' Compensation. <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 AUTHORIZED REPRESENTATIVE <br />Risk Management Division ✓ � (1 ' <n.„,R R6kMmr8lanadDNWwt <br />20 Civic Center Plaza e!l 4s1tW 4 REVIEWED&MPRavwSr. <br />Santa Ana, CA 92702 N <br />ACORD 25 (2016/03) ©1988.2015 ACORD C a �a F% ` Z MA44-1 <br />The ACORD name and logo are registered marks of ACORD Risk Management Analyst <br />
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