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CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY)
<br />11/04/2010
<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, 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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Insurance Office of America, Inc.
<br />DBA IDA Insurance Services
<br />1775 Hancock Street, Ste. 180
<br />San Diego, CA 92110
<br />CONTACT
<br />NAME: Sara Cabral
<br />a�NN :-EXt), 619.574.6220 a� No.619.574.6288
<br />-
<br />E-MAIL - -
<br />ADDRESS:
<br />PRODUCER
<br />CUSTOMER ID #:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURED
<br />INSURER A : Travelers Prop Cas Co of Amer
<br />25674
<br />Gillis & Panichapan Architects, Incorporated
<br />INSURER B: OneBeacon America Ins Co
<br />2062.1______
<br />2900 Bristol St. Suite G205
<br />INSURER C:
<br />Costa Mesa, CA 92626
<br />INSURER D:
<br />---.
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />INSURER E
<br />GENERAL AGGREGATE $ 2,000,000
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 10/11 GL/AU/UM/WC/PL 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 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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYV
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />- CLAIMS -MADE rXJ OCCUR
<br />6802841L495 07/24/2010
<br />07/24/2011
<br />EACH OCCURRENCE $ 1,000,00_0
<br />DAMAGE TO RENTED
<br />PREMISES (Ea occurrences $ 300,000
<br />MED EXP (Any one person) $ 5,000
<br />A
<br />---.
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG $ 2,000,000
<br />POLICY X PRO-
<br />JECT LOC
<br />$
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED AUTOS
<br />BA9193L09101/11/2011
<br />J !`ALL
<br />01/11/2012
<br />COMBINED SINGLE LIMIT $
<br />(Ea accident) 1,000,000
<br />- - -- _
<br />BODILY INJURY (Per person) $�
<br />BODILY INJURY (Per accident) $
<br />A
<br />---
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />-
<br />s -
<br />- --- _-
<br />PROPERTY DAMAGE $
<br />(Per accident)
<br />NON -OWNED AUTOS
<br />Laui : d
<br />$
<br />$
<br />�SSIATA, �
<br />UMBRELLALIAB
<br />tXTOCCUR
<br />CUP6785Y33807/24/2010
<br />07/24/2011
<br />EACHOCCURRENCE $ 1,000,000
<br />AGGREGATE $ 1 000 Q00
<br />rA
<br />EXCESS LIAB
<br />- -
<br />LAIMS-MADE
<br />DEDUCTIBLE
<br />-- — -
<br />$
<br />X
<br />RETENTION $ 0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />N / A
<br />406030061109/01/2010
<br />09/01/2011
<br />X I WC STATU- t JOTH-1AND
<br />TORY LIMITS LER_
<br />E.L. EACH ACCIDENT $ 1 000 000
<br />,
<br />—
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />$1,000,000 Per Claim
<br />$2,000,000 Aggregate
<br />B
<br />DESCRIPTION OF OPERATIONS below
<br />Professional Liability
<br />LAIMS MADE
<br />DPL03361
<br />$5,000 DEDUCTIBLE
<br />11/08/2010
<br />11/08/2011
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
<br />Re: All Operations of the Named Insured
<br />The City of Santa Ana is additional insured as respects general liability per the attached endorsement.
<br />CER l iFiGA I E HOLDER CANCFLLATIAN
<br />©1988-2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />The City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Michelle Walker
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza M-36
<br />PO Box 1988
<br />Sa to Ana, CA 92702-1988
<br />Kelly Howell/TENUTE
<br />©1988-2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
<br />
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