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DAVID VOLZ DESIGN LANDSCAPE ARCHITECTURE, INC.
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DAVID VOLZ DESIGN LANDSCAPE ARCHITECTURE, INC.
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Last modified
1/3/2022 9:57:44 AM
Creation date
1/3/2022 9:54:08 AM
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Contracts
Company Name
DAVID VOLZ DESIGN LANDSCAPE ARCHITECTURE, INC.
Contract #
A-2021-246
Agency
Public Works
Council Approval Date
12/7/2021
Expiration Date
12/6/2024
Insurance Exp Date
3/14/2022
Destruction Year
2029
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Ole <br />Ity Sined by Tod Phnom <br />Tori Pierson.R72Pd191211595J36 DBW <br />ACORN® CERTIFICATE OF LIABILITY INSURANCE <br />`/ <br />DAM(MMMDNYYY) <br />1 11/15/2021 <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 NEGATIVELYAMEND, 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 Tina Cowie <br />NAME: <br />Cornerstone Specialty Insurance Services, Inc. <br />PHONE (714) 731-7700 AX (714) 731-7750 <br />AIC No Ext: A/C No: <br />14252 Culver Drive, A299 <br />EAD-MAILORESgna@comerstonespecialtycom <br />$: <br />INSURER(S)AFFORDING COVERAGE <br />NAIC # <br />Irvine CA 92604 <br />INSURERA: RLI Insurance Company <br />13056 <br />INSURED <br />INSURER B: Great American Insurance <br />16691 <br />DAVID VOLZ DESIGN LANDSCAPE ARCHITECTURE, INC. <br />INSURER C: <br />151 Kalmus Drive, Ste. M-8 <br />INSURER 0: <br />INSURER E <br />Costa Mesa CA 92626 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 21122 COVERAGES REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADOL6UBR <br />INSR <br />MD <br />POLICY NUMBER <br />POLICYEFF <br />MMIDDIYYYY) <br />P L YE%P <br />(MMIODNYYYJ <br />LIMITS <br />x <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />EACH OCCURRENCE <br />$ 2,000.000 <br />PREMISES Ea Wcurrrnce <br />$ 11000,000 <br />x <br />MED EXP (An onePerson) <br />$ 10,000 <br />ADDTL INSURED / PRIMARY <br />X1 <br />BLANKET WVR OF SURRO <br />PERSONAL B ADV INJURY <br />$ INCLUDED <br />A <br />Y <br />Y <br />PSB0001408 <br />03/14/2021 <br />03/14/2022 <br />GEN-LAGGREGATE LIMITAPPLIES PER: <br />POLICY [g JECPROT- ❑ <br />LOC <br />GENERA -AGGREGATE <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 />$ 2,000,000 <br />BODILY INJURY (Par person) <br />$ <br />ANYAITIO <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />PSB0001408 <br />03/14/2021 <br />03/14/2022 <br />BODILY INJURY (Per accident) <br />$ <br />x <br />HIRED NON -OWNED <br />AUTOS ONLY !� AUTOS ONLY <br />PROPERTY DAMAGE <br />Par accitlenl <br />$ <br />It <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED <br />I I RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNEWEXECIJIIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />Y <br />PSW0001346 <br />03/14/2021 <br />03/14/2022 <br />PER OTH- <br />%� STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />EL.DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />B <br />Professional Liability <br />Claims Made <br />DPP4204131 <br />03/14/2021 <br />03/14/2022 <br />Each Claim <br />Annual re ate <br />99 9 <br />$2,000,000 <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 />RE: Santa Ana Dog Park, City of Santa Ana <br />The City, its officers, officials, employees, and volunteers are named as Additional Insured for General Liability but only If required by written Contract with the <br />Named Insured prior to an occurrence and as per attached endorsement. Coverage is subject to all policy terms and conditions. `30 days notice of <br />cancellation, except for 10 days notice for non-payment of premium. For Professional Liability coverage, the aggregate limit is the total insurance available <br />for all covered claims reported within the policy period. <br />City of Santa Ana Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana <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 KKKmanase^r""�11°` <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />
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