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Gill <br />Johnson -Frank & Associates, Inc. <br />On -Call Construction Surveying Services RFP No. 19-090 <br />Santa Ana Public Works Agency <br />a oa CERTIFICATE OF LIABILITY INSURANCE <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, E)(TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(Sj, AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollay(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement- A Statement on <br />this certificale dose net conM1er rights to the cer ificate holder In lieu of auOn endomement(3l. <br />,nDu-R ICA Insurance Services <br />O.IUACT <br />NAME. Betty TRIP <br />130 Vands. Suite 250 <br />Alim Viejo, CA 92656 <br />PHONE <br />MIErn: 949-297-5962 (A,E, NI949-297-5913) <br />ADDRE99: hotly.Idm@ioausa. Lam <br />INSIO CROD AFFORDING COVERAGE NAN:4 <br />www-loaulini CA License RDEG7768 <br />INBURea A: RLI Insurance Company 13066 <br />IxsRRED <br />Johnson -Frank & Associates, Inc. <br />IxauxExal <br />5150 E. Hunter Avenue <br />I.coke. D-. _. <br />Anaheim CA 92807 <br />wsuram o: _ <br />mSVRm E' <br />ASURFR F: <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 />EXCLUSIONSAND CONDMONS OF SUCH POLICIES. LIMITS SI10byR MAY HAVE BEEN REDUCED BY PAID CLASS. <br />IH�R 3ypEOPINSUMHCE ASUIL POLICYNUMBER Y tbORPRO <br />NNRNNYY�YV MIS <br />A J.CMMER LGexe UA W J J PSBODUlW1 'vO2018 <br />"0"019 tALx occuxxENCE s1.000000 <br />CIAE.Ia#UDE J'. oCCRN Scheduled Rl Entlt <br />PBEMISES(Es cmurervul 91.000,000 <br />sPP83130212 <br />V Pl"/NonCon_ Professional Services <br />MED EXPIam ore OxiMll 310.000 — <br />✓- Wvr of Bubr � penormed by the Insured <br />PERsnxnLa Am' euuar 91,000.000 <br />GEN'L AGGREGATE LIMIT APPLIES PER. are E}chided <br />GENERALAGGI1ECJrE 3Z0GgODD <br />_ Poll" J jFCT J_ I0, <br />PRODUCTS_COMPIOPAGG 82.090,000 <br />G1,ER <br />I 3 <br />A Au onowLEumem, J V PSA0001078 12Hrzo18 <br />iviaciq ;mo11,000000 <br />-V Axv Aum Designated Insured Endt <br />8oOr YeYIMY;FA,PAPAAI 3 <br />'L, TO SCHEDULED NCA2W81013; PnnvNonCon <br />eeoav lxivav (Peamamn 3 <br />_ coos onlr and Slid Wvr of Subr <br />HIRED_Auras <br />J AUTOS ONLY J AUTOS IXLLY included On pit 2 Of FOmt <br />IPer Pa-ctl RAGE 3 <br />PdrvNonCon J `OMrnf Subr OPPA3000313 <br />3 <br />A VNBRELLAUes J DCCRft PSED001230 1v1201B 12/12019 EALII occuRRENCE 34.000,000 <br />__ <br />✓ OIGEss lrpe CUW91rHDE E%fJUdes Professional AGGxEW TE 34 OOO OOD <br />_-- _ Liability <br />°CO IIEiEM OH $ <br />A ✓ F5und.(S95 1v1+2018 Ivt/2019 J <br />ANUMPeCaNPExeATN)N STATCTF EAH <br />ANn E31PLDYERS WaBM Y/x Waiver of Subr alien - <br />ANYPRG1,ume IPfA'Lift J(ECmIVE EL EACH ACCIDENT 31.000 DDD <br />aFFKEwNEMSERExcLucEm �Y NIA EntlteWC04o3060484 - <br />nNNl [.L OIaGSF [A JJ.ffLOYEf, 31.000•gD0 <br />(YAA <br />weo <br />DESCRION OF OPERATIONS EcM EL DISEASE. POLICY LIMIT 31.000000 <br />A Professional Liability <br />RDP0034448 1v1R01a <br />1v1R019 S2. D00,000 Each Claim <br />Claime-Made <br />82,000,00DAggregate <br />DESCPoPmD°MOPEeATwxerLOCAn°NarVHICLU(AGGRD mt Adai ReMM xresual mry W NNermir We IffninieE1 <br />Certificate Holder is an Additional Insured with rasped to General Liability (GL) and Automobile Liability but only when required by wake contract <br />with the Insured poor to an occurrence as per Endorsements norcd above- GL includes Separation of Insureds and Contractual Liability per limitations <br />in the SusinessOwnem' Coverage form. A Workers Compensation Waiver of Subrogation as noted above is included for the person or organization named <br />in the Schedule that are parties to a contract mouldir this Endolsemenl, Provided that contract is executed before the loss. Coverage subject IG all <br />poem, terms, mnditi°ns, limitations and ...amens 3 Day Notice of CanCBNiO Days for Non -Payment in accordance with Polity provisions <br />RFP 17-M and Agreement RA-2011 098MA-2017159 <br />CliV of Santa Ana, its officers and employees <br />P Yees <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />P 6 BOX <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />C27 <br />Santa AnaaCA 02702 <br />ACCORDANCEWITHTHEMUCYPROVIBIONS. <br />AUTRDRrLEDREPRESENTATNE � // <br />(AVCI Alias k. I ram <br />01946305 AGGRO CORPORATION. All rights reserved. <br />ACORD 25 (20161031 The ACORD manna and logo are registered marks of ACORD <br />L—,1a r I=:In I :I. 'I'll v .S....P. rrr+nq Pan. .. I—', I 1 rH rR. a - <br />5150 E. Hunter Ave. 35 Anaheim, CA 92807 <br />(714) 777-8877 alanfrank@johnson-frank.com FAX: (714) 777-1641 <br />