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OILLS:PA-01 CABRALS
<br />.4`cof a CERTIFICATE OF LIABILITY INSURANCE
<br />DATE 8/24/1201201 ,
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terns 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 />IOA Insurance Services Licg0 E67768
<br />4350 La Jolla Village Drive, Suite 900
<br />San Diego, CA 92, 22
<br />ONTA Sara Cabral
<br />NAME-
<br />_
<br />P._. . (619) 574-6220 ii°s
<br />ac No : 619 574-6288
<br />X"DoR . Sara.Cabral ioausa.eom
<br />=__ __ INSU RfiR(S) AFFORDING COVERAGE NAIL •
<br />INSURER A: RLI Ina Co 13056
<br />UNITS
<br />INSURED
<br />INSURER 8: OneBeacon America Ina Co 20621
<br />INSURER C:
<br />Gillis S Panichapon Architects, incorporated
<br />INSURER D
<br />2900 Bristol St. Suite G205
<br />Costa Mesa, CA 92626
<br />INSURER E -
<br />INSURER F,
<br />GUVCKAC9Cti CCKTIFICATC IMLIMIHEKe RFVIS If1N NIIORCO•
<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. NOTIMTHSTANDING 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
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />.NSR
<br />LTR
<br />TYPE OF INSURANCE
<br />POLICY MUY BER
<br />POLICY
<br />MM
<br />POLICY P
<br />MYIDD/YYYY
<br />UNITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE S
<br />1.000,000
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />PSB0001119
<br />7/24/2011
<br />7/24/2012
<br />PREMISES 2M-1renca S
<br />,.000,000
<br />MED EXP ArIoro — S
<br />10,000
<br />PERSONAL A ADV INJURY S
<br />,,000,000
<br />GENERAL AGGREGATE $
<br />2,000,000
<br />GEN•L AGGREGATE LIMIT APPLIES PER
<br />POLICY X PRO- LOG
<br />PRODUCTS -COMPIOP AGG S
<br />2,000,00
<br />S
<br />A
<br />AUTOMOBILE UAeILRYCEOMBINtlEaDI
<br />X ANY AUTO
<br />PSA0001116
<br />6/1/2011
<br />6/1/20,2
<br />INGLE LIMIT S
<br />1,000,000
<br />BODILY INJURY(Par parson) S
<br />ALL O�ED SC
<br />Sc
<br />AUTO, AUTOS ULED
<br />NON-OYMED
<br />HIRED AUTOS AUTOS
<br />BODILY INJURY (Par s¢MerY) S
<br />RO ERTY DAMAGE S
<br />Par,ds
<br />S
<br />X UMBRELLA WBX OCCUR
<br />O=CAU"-MADE
<br />EACH OCCURRENCE S
<br />1,000,000
<br />A
<br />EXCESS LLAa
<br />PSE0001038
<br />7/24/2011
<br />7/24/2012
<br />AGGREGATE s
<br />1,000,0
<br />DED X I RETENTION
<br />r,
<br />A
<br />MORXERS COMPENSATION
<br />ANO EYPLOYERY LIABILITY
<br />ANY PROPRIETORIPARTNERIEXECUrIVE Y I N
<br />OFFICERM
<br />OFFICER/MEMBER EXCLUDED?
<br />NIA
<br />PSW0001177
<br />9/1/2011
<br />9/1/2012
<br />X Y„C STATU- OTH-
<br />E.L. EACH ACCIDENT S
<br />1,000,000
<br />EL DISEASE - EA EMPLOYE- S
<br />1.000,000
<br />n yaCtl
<br />DESRIPTION OF OPERATIONS Calow aanYba vtlar
<br />E.L. DISEASE -POLICY OMIT 5
<br />,,000.000
<br />B Professlonal Llab DPL033610
<br />11/8/2010 11/8/2011 Per Claim
<br />1,000,000
<br />B Ded.-55,000 DPI -0336110
<br />11/6/2010 11/8/2011 Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (A-1, ^CORD tel, AtlditS—I Rsms BelrtluN, X mos sacs b ngWra
<br />Re: All Operations of the Nomad Insured ���PRQ V EO AS TO FORM
<br />TheCity of Santa Ana Is additional Insured as respects g—ral liability per the
<br />attached endorsement
<br />aura Stitt S ed}
<br />Assistant City A torney
<br />CERTIFICATE_HOLDER
<br />CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />The City of Santa Ana Attn: Michelle Walker
<br />20 Civic Center Plaza M-36
<br />PO Bo)c ,986
<br />AUTHORIZED REPRESENTATIVE
<br />5 Pil mt<d+t •Il.(Q
<br />Santa An CA 92702-1988
<br />(0 1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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