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<br />GILLS,PA-01 ROSEM
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DAT$ 1/20lYYYVI
<br />/141zo14
<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($), 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 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 Ileu of such endorsement(s).
<br />PRODUCER License # QE67768
<br />IDA Insurance Services -SD
<br />4360 La Jolla Village Drive, Suite 000
<br />San Diego, CA 92122
<br />CONTACT
<br />NAME; Erica Wilson
<br />PRONE
<br />a
<br />ATZ-
<br />No Ext: (619) 974.6220 �ac, Not+ (619) 574.6288
<br />nMnEes:
<br />Erica.WilsORtl lOauaa.com
<br />INSURER S)AFKORDING GtlVERAGE NAICk
<br />INSURERA,RLIInsurance Compaa 13056
<br />INSURED
<br />Gulls & Panlchapan Architects, Incorporated
<br />2900 Bristol St, Suite G206
<br />Costa Mesa, CA 92626
<br />INSURERB;AtlantlC9peClaltylDSUranCeCom an 27154
<br />INSURERC:
<br />INSURER D:
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSU ED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 />INTRI-Rpp
<br />TYPE OF INSURANCE
<br />The City of Santa Ana
<br />POLICYNUMBUR
<br />MMIDDMr
<br />M I DrfYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ 2,000,QQO
<br />CLgIM9 YtAOE OCCUR
<br />X
<br />•PS80001118
<br />0772412014
<br />07124I2019
<br />pRGw6E9 Ea aca;nenca) $ 1,000,000
<br />_
<br />X
<br />MED E%P A' one person) s 10,000
<br />Contractual Llab.
<br />X
<br />I Ded.:$D
<br />PERSONAL &AOV INJURY $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />OENERALAGGREGATE S 4,000,000
<br />POLICY�LOC
<br />PRODUCTS - COMP/OP AGO $ 4,000,00
<br />$
<br />OTHER
<br />AUTOMOBILE LIABILITY
<br />LE UMI'r $ 1,000,000
<br />�(Ee ewidonl .....................................
<br />A
<br />X ANYAUTO
<br />PSA0001116
<br />06141/2014
<br />06/01/2010
<br />BODILY INJURY (Par persan) $
<br />AUTOBmEp AlO1THO81LED
<br />HIREDAUTOS NON -OWNED
<br />AUTOS
<br />90 DILY INJURY (Par accident) $
<br />R avc,-dedt GE $
<br />_......,�
<br />$
<br />X camp$t00o X Coll$1,OOQ
<br />X
<br />UMBRELLA LIAR X
<br />OCCUR
<br />EACH OCCURRENCE�W $ 3,000,000
<br />AGREE? TE $ 3,000,000
<br />A
<br />EXCESS LAB
<br />ICLAIMS-MADE
<br />PSE0001038
<br />07/2412014
<br />07/2412015
<br />OED I X I RETENTION 0
<br />_ $
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNERiE%ECUTNE YIN
<br />OFFOCRIMCMBER EXCLUDED?
<br />(Mandetaryln NH)
<br />NIA
<br />.,...........-4�-WM-�mm
<br />SWUOQ1177
<br />09/07/2014
<br />0810112015
<br />PER DTH'
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT $ 1,000,00
<br />E.L. DISEASE -EA EMPLOYEE $ 1,000,000
<br />If yes desadbe under
<br />DE64tRIPTIONOROPERATIONS We,,
<br />EL. DISEASE -POURQMn $ 1,000,000
<br />B
<br />Prof Liab/Clms Made
<br />DPL28T613
<br />11/0812013
<br />_
<br />1110812014
<br />Per Claim 1,000,00
<br />B
<br />Dad.: $Sk Per Claim
<br />DPL207613
<br />11/08/2013
<br />11i
<br />gg ate 2,000,00
<br />DESCRIPTION OT' OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Adetional Remarks Scbeduee, may be an a 11 KM
<br />Re: All Operations
<br />The City of Santa Ana is Additional Insured with respect to General Liability per the ails had r ant u e y written con DEC
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium Ina o . "fli1p2Ce yS111
<br />for Assistant Cite Attorney
<br />CERTIFICATE 14OLDER CANCELLATION
<br />©1908-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<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
<br />_
<br />AUTHORIZED REPRESENTATIVE
<br />Attn: Michelle Walker
<br />20 Civic Center Plaza M-36
<br />P.O. Box 19881
<br />-1�-^J I I i�
<br />'4'i
<br />Santa Ana CA 92702-198B
<br />©1908-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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