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PSOMAS 1 - 2005
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PSOMAS 1 - 2005
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Entry Properties
Last modified
1/3/2012 2:22:10 PM
Creation date
10/5/2005 12:15:35 PM
Metadata
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Template:
Contracts
Company Name
Psomas
Contract #
N-2005-040
Agency
Public Works
Expiration Date
12/31/2005
Insurance Exp Date
10/15/2006
Destruction Year
2010
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<br />Client#. 6184 <br /> <br />PSOMAS <br /> <br />ACORD," CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDfYYI <br />05/13/05 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />P. O. Box 10550 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Santa Ana, CA 92711-0550 <br />714427-6810 I INSURERS AFFORDING COVERAGE <br />IN$URED . INSURER A: Hartford Fire Ins. Co. <br /> PSOMAS ~:------- - ---- -- - <br /> INSURER B"o Travelers Property Casualty Co of Am <br /> 11444 West Olympic Blvd.,Suite 750 INSURER c: American Automobile Ins. Co. <br /> West Los Angeles, CA 90064-1549 r::SURER 0: Great American Assurance Co. <br /> -- -----. ---- ..--- .-....-.- -- -- -- <br />I INSURERE: <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BE:EN REDUCED BY PAID CLAIMS. <br />-- SR -- __u -- - POLICY EFFECTIVE POL.ICY EXPIRATION <br />TR TYPE OF INSURANCE POL.lCY NUMBER AT 0 D MM D <br />A GENERAL.L.IABILlTY 157CESOA1659 10/15/04 <br />WCOMMERCIALGENERALUABILITY I <br />I - CLAIMS MADE IliJ OCCUR IINDP. CONTRACTORS <br />X CONTRACTUAL INCLUDED <br />X BFPD, XCU _ <br /> <br />COVERAGES <br /> <br />B <br /> <br />GEN'L AGGREGATE UM IT APPLIES PER: <br />POLICY X PRO~ IX' LaC <br />AUTOMOBILE L.IABIL.lTY <br />-=1' ANY AUTO <br />-f;J- -- ALL OWNED AUTOS <br />_ SCHEDULED AUTOS <br />+1 HIRED AUTOS <br />H NON-OWNED AUTOS <br /> <br /> <br />~.GARA_ GE LIABILITY <br />I_~I ANY AUTO <br /> <br />f"'l.EXCESS LIABILITY <br />1_---' OCCUR D CLAIMS MADE <br /> <br />DEDUCTIBlE <br />RETENTION <br />C WORKERS COMPENSATION AND <br />; EMPLOYERS' L.IABIL.ITY <br />\ <br /> <br />o I OTHER Professional <br />~iability <br /> <br />L.IMITS <br /> <br />10/15/05 <br /> <br />EACH OCCURRENCE $1 000 000 <br />FIRE_ DAMAGE_(Any OflB fi_~eL_$1,OOO,OQL_ <br />ME-DEXP (Any one per$on) $10000 <br />I PERSONAL & ADV INJURY $1 000 000 <br />GENERAL A_GGREGA~_ ~~OO,OOO <br />. PROqUCTS .:E_OMP/OP AGG $?,OpO.O()O ___ <br /> <br />IP810153D892803 <br /> <br /> <br /> <br />I <br /> <br />10/15/04 <br /> <br />10/15/05 <br /> <br />'1,000,000 <br /> <br />COMBINED SINGLE LIMIT <br />(Eaacc'ldenl) <br /> <br />BODILY INJURY <br />(PBrpersOrl) <br /> <br />BODILY INJURY <br />I (PBracclderlt) <br />------------- <br />P.ROP.ERTY DAMAGE <br />(Peracciderlt) <br /> <br />APPROVED js TO PO <br />j~' <br />/JLv-x <br /> <br />M <br /> <br />. <br /> <br />~U:1.:0 ONLY. EA A(;-CIDENI ~ <br /> <br />h <br /> <br />OTHER THAN <br />AUla DNLY: <br /> <br />EAACC $ <br />AGG <br /> <br />As~islant Ci y Attorney <br /> <br />EACH OCCURRENCE <br /> <br />~GGREGATE <br /> <br />. <br />. <br /> <br />I WZP80925342 <br /> <br />110/15/04 <br /> <br /> <br />10/15/05 <br /> <br />x wc sITtJu. OTH_ <br /> <br />E.L. EACH ACqDE~ . $1,()~0,()_0l!__ <br />E.L. DISEASE - EA EMPLOYEE $1,000,000 <br />E.L. DISEASE -POLlCYLlMIT $1,000,000 <br />I $1,000,000 per claim <br />$1,000,000 annl aggr. <br /> <br />EDN5850409 <br /> <br />I <br /> <br />10/15/05 <br /> <br />DESCRIPTION OF OPERA TIONS/LOCAIIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />General Liab. policy excludes claims arising out of the performance of prof. services <br />2SAN050700-Task 00000 <br />On Call agreement for survey work, preparation of legal descriptions and <br />preparation of plat maps <br />(See Attached Descriptions) <br /> <br />CERTIFICATE HOLDER <br /> <br />AD D mONAlINSURED; IN SU RER LETTER: <br /> <br />CANCELLATION <br /> <br />City 01 Santa Ana <br />Att: Kent Jorgensen <br />Public Works Agency <br />20 Civic Center Plaza; PO Box 1988 M36 <br />Santa Ana, CA 92702 <br /> <br />SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BECANCELLED BEFORETHE EXPIRATION <br />DATE THEREOF, IHE ISSUING INSURER WILLDlJtIWMIXlJIxJPMAIL3.0.--DAYSWRITTEN <br />NOTICE TOTHE CERTIFICATE HOLDERNAMEDTOTHE LEFT, B~){I:~U""KIGXXX <br />MfDX~UOkIlXUX)(XMDIJVU('1J)(nx~laIX x <br />""'.-."""""."" <br />AUTHORIZED REPRESENTATIVE <br /> <br />ACORD 25-S (7/97)1 <br /> <br />012 <br /> <br />#S127297/Ml13620 <br /> <br /> <br />LL <br /> <br />@ ACORD CORPORATION 1988 <br />
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