W. Koo & Associates 3 - Laserfiche WebLink

Home Browse Search

-1 1 9/16 ACOR ., CERTIFICATE OF LIABILITY INSURANCE M/DD/YY) 09/16/OB PRODUCER 1-866-220-4625 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Holmes Murphy and Associates - Omaha ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2637 South 158th Plaza ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 Omaha, NE 68130 INSURERS AFFORDING COVERAGE INSURED csiZ6 INSURER A: Zurich American Insurance Com an /#16535 Post, Buckley, Schuh & Jernigan, Inc. d/b/a PBS&J INSURER B: Zurich American Insurance Company / #16535 2001 NW 107th Avenue INSURER C: steadfast Insurance Company/#26387 Miami, FL 33172-2507 INSURERD: INSURER E: 'OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY GLO 9139458-02 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 1,000,000 rA X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 25,000 CLAIMS MADE a OCCUR PERSONAL &ADV INJURY $1,000,000 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO-JECT X LOC B AUTOMOBILE X LIABILITY ANY AUTO BAP 9139457-02 09/30/08 09/30/09 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X X HIRED AUTOS" NON -OWNED AUTOS Contractual Liability1-62 X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG C EXCESS LIABILITY AUC 508762104 09/30/08 09/30/09 EACH OCCURRENCE $25,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 25, 000, 000 $ $ DEDUCTIBLE $ RETENTION $ 0 A WORKERS COMPENSATION AND WC 9139459-02 09/30/08 09/30/09 X I WC STATU- OTI- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEEI $ 1, 000,000 E.L. DISEASE -POLICY LIMIT 1 $ 1,000,000 OTHER 3 3 S DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: A50550.05 & A2005-012; Santa Ana Bridge Rehabilitation. Named Insured Includes: W. Roo & Associates, Inc., a division of PBS&J. The City of Santa Ana, Public Works Agency, and the Ci of Orange Coun y on �er$iiiability with respect to the operations of the insured on the above project. I, M I 1 C nvLVCrt I I ADDITIONAL INSURED; INSURER LETTER: l.A149.t LLA 1 IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Santa Ana, City of DATE THEREOF, THE ISSUING INSURER WILL ffJMX9WY4 MAIL 90 DAYS WRITTEN Public Works Agency NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 9[0[]EXIiXgEQCXEiAYKX Attn: Mindy Ly 20 Civic Center Plaza X g jigxxxXXXXXXXXXXXXxxxxxxxxx%xxxxxxXXXXXXXXXXXXXXXX Santa Ana, CA 92702 USA AUTHORIZED REPRESENTATIVE C�-!f P0,UKU ZO-b (11Uf) ganderson 9771538 Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600 Q ACORD CORPORATION 1988