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ACC>J br CERTIFICATE OF LIABILITY INSURANCE <br />lh+...,- """ <br />DATE(MMIDD/YYYY) <br />1 11/13/2014 <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 />Dealey, Renton & Associates <br />P. O. BOX 10550 <br />Santa Ana CA 92711-0550 <br />CONTACT <br />NAME: <br />PHONE <br />�--"� ���`� .��� <br />No ExtL714-427-6810 714-427-6818 <br />EMAIL <br />_ SURER COVERAGE <br />NAIC # <br />INSURER A :ACE. American Insuran__c_e Company <br />s <br />22667 <br />INSURED PSOMAS <br />INSURER B: <br />_ <br />PSOMAS <br />555 South Flower Street, Suite 4300 <br />Los Angeles CA 90071 <br />INSURER C <br />--���- <br />INSURER D <br />INSURER E : <br />INSURER F; <br />COVFRAGFS CFRTIFICATF NIIMRFR° 988144384 01=X11Ic1nKI KII InnRCD• <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 />I <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />EFF <br />MOLIC YYYY <br />EXP <br />MMY %DDYIYYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE $ <br />DAMAGE TO RENTED <br />PREMISE jEa occurrence) $ <br />__ <br />MED EXP (Any one person) $ <br />_ <br />PERSONAL & ADV INJURY $ <br />GENS.. AGGREGATE LIMIT APPLIES PER: <br />POLICY1:1 PRO 0 LOC <br />JECT <br />GENERAL AGGREGATE $ <br />PRODUCTS -COMP/OP AGG $ <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT $ <br />Ea accident) <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />SCHEDULED <br />ALL AUTOS UOS <br />BODILY INJURY (Per accident) $ <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE _ <br />Per accident $ <br />UMBRELLA LAB <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION$ <br />_ <br />$ <br />WORKERS COMPENSATION <br />I PER I OTH- <br />AND EMPLOYERS' LIABILITY Y / N <br />STATUTE ER <br />E.L. EACH ACCIDENT $ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? Li <br />N / A <br />E.L. DISEASE - EA EMPLOYE $ <br />(Mandatory in NH) <br />If yes, describe under <br />---- — <br />E.L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS below <br />A <br />Professional Liability <br />Claims Made <br />623638381006 <br />10/15/2014 <br />10/15/2015 <br />Per Claim $1,000,000 <br />Annual Aggregate $1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />30 Day Notice of Cancellation/10 Day notice for Non -Payment of Prem <br />2SAN050900; On -Call Engineering and Landscape Architecture Services; Executed Agreement No. A-2008-219. <br />2SAN050902 Grand Avenue Storm Drain From Channel to 4th Street Design <br />PSOMAS AGREEMEN N A-2008-219 REVIEWED BY: UNICE HEREDIA PG 1 OF 7)y <br />1 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Attn: Clerk of the City Council <br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />I 4A,,. <br />@ 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />