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FIELDMAN, ROLAPP & ASSOCIATES 1
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FIELDMAN, ROLAPP & ASSOCIATES 1
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Entry Properties
Last modified
12/3/2015 4:33:14 PM
Creation date
10/7/2005 10:47:09 AM
Metadata
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Template:
Contracts
Company Name
Fieldman, Rolapp & Assoc
Contract #
A-2005-223
Agency
Finance & Management Services
Council Approval Date
9/19/2005
Expiration Date
6/30/2007
Insurance Exp Date
4/1/2007
Destruction Year
2010
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To: City sof Santa Ana From: Blanca Roque 3-27-06 2:31pm p. 2 of 6 <br />w <br />ACORO �., Ir <br />.2. <br />1Yf,i <br />)t`YI@ <br />' 3 14s1C <br />Derem tlp'A"q,3/27/ <br />:- . v��� ,tt:i^��.,y.€y n:'!�;: Ir,,...�v <br />)„,4 <br />�':I,Wu):TI?t!^ <br />la�waa ,,,' , <br />,. <br />°C�. ' <br />Proaucer Blanca Roque <br />,�1y,��1,&• ,; .?IId,e;p'.,F n5I{wg�ll� <br />0C <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />Wood Gutmann & Bogart Insurance Brokers <br />THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />15901 Red Hill Ave., Suite 100 <br />COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Tustin CA 92780 <br />714 505.7000 <br />www.wgbib.com <br />INSURER Hartford Casualty Insurance Company <br />P nY <br />License No. 0679263 <br />A <br />INSURER <br />B <br />Insured <br />Fieldman, Rolapp & Associates 2 0¢S—."2 <br />INSURER <br />C <br />19900 MacArthur Blvd, #1100 <br />Irvine CA 92612 <br />INSURER <br />p <br />..... 7% <br />THE POLICIES OF INSURAN E LISTED ELOW H VE BEEN IS UED <br />TOT E INSURE NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF <br />ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE <br />AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />POLICY <br />POLICY <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />PoLICY NUMBER <br />EFFECTIVE <br />DATE <br />EXPIRATION <br />DATE <br />LIMITS <br />MM/DO/YY <br />MM/DD/YY <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />COMMERgAL GENERAL UAB <br />72SBAAF9892 <br />4/1/2006 <br />4/1/2007 <br />FRE DAMAGE (My 1Bre$ <br />4l14 CLAIMS MADE FZ OCCUR <br />MED EXP one . $ <br />PERSONAL& ADV INJURY E <br />GENERAL AGGREGAlbffftff <br />TE $ <br />GENT AGG OMIT APPLIES PER <br />PRODUCTS-COMP/OP AGG <br />$$ <br />POLICY PROJECT LOC <br />AUTOMOBILE <br />LIABILITY <br />AUTO <br />72UECTQ4293 <br />4/12006 <br />4/1/2007 <br />COMBINED SINGLE UNIT $ 1,000,00 <br />ALL OWNED AUTOS <br />BODILY INJURY <br />SCHEDULED AUTOS <br />(Per person) <br />]ANY <br />HIRED AUTOS$ <br />BODILY INJURY <br />NON -OWNED AUTOS <br />(Per exitlera) <br />PROPERTY DAMAGE <br />(Per exltlm) $ <br />GARAGE LIABILITY <br />AUTO ONLY -EA AGgDEM $ <br />ANY AUTO <br />OTHER THAN EA ALC $ <br />AUTO ONLY: AGG$ <br />EXCESS LIABILITY <br />OCCUR El CLAIMS MADE <br />72SBAAF9892 <br />4/12006 <br />4/12007 <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />Is <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />WORKERS' COMPENSATION & <br />EMPLOYERS' LIABILITY <br />STATUTORY LIMIT HER` A Yt`^'u "L}xc,'^"✓,E <br />72WBCNU7013 <br />4/12006 <br />4/12007 <br />EL EACH $ <br />AET <br />EL DISEASESE EEA EMPLOYEE $ <br />EL DISEASE POLICY LIMIT $ 1 Min (in <br />DESCRIPTION OF OPERATIONS/LOCATIONSfVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additioal <br />insureds per attached SS 00 08 04 01. <br />Y��fy " <br />v, <br />� `S� 1�' <br />1� "� i�i1\ iE <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />Attn: Clerk of the City Counsel 3Q--_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION <br />OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE. <br />20 Civic Center Plaza (M-30) SENTATIVES. 10 Days for Non -Payment of Premium <br />Santa Ana CA 92702-1988 Au <br />REPRESENTATIVE <br />Den Gorman <br />
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