Laserfiche WebLink
Client#: 6428 A — a roo 4? —e, <br />ACORD- CERTIFICATE OF LIABILITY <br />INSURANCE <br />DATE (MMIDDfYYYY) <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />TR <br />07/05/11 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Dealey, Renton & Associates <br />P. O. Box 10550 <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Santa Ana, CA 92711-0550 <br />A <br />714 427-6810 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />INSURER A: Travelers Property Casualty Co Of Am 25674 <br />Tatsumi and Partners Inc. <br />49 Discovery, Suite #120 <br />Irvine, CA 92618 <br />INSURER B: XL Specialty Insurance Co. 37885 <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />General Llab. <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REOUI REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />TR <br />N R <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EMFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />A <br />GENERAL LIABILRY <br />68020941-400 <br />06/17/11 <br />06/17/12 <br />EACH OCCURRENCE $2,000,000 <br />AUTHORIZED REPRESENTATIVE <br />X COMMERCIAL GENERAL LIABILITY <br />General Llab. <br />DAMAGE TO RENTED $2,000,000 <br />CLAIMS MADE r OCCUR <br />excludes claims <br />MED EXP (Any one person) $10,000 <br />PERSONAL 8 ADV INJURY s2,000,00 <br />arising out of <br />GENERAL AGGREGATE $4,000,000 <br />the performance <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG s4,000,000 <br />of professional <br />POLICY PRO LOC <br />Se rvIC03_ <br />A <br />AUTO <br />MOBILE LIABILITY <br />ANY AUTO <br />BA4669LO23 <br />06/17/11 <br />06/17/12 <br />COMBINED SINGLE LIMIT $1,000,QQQ <br />(Ea accident) <br />BODILY INJURY $ <br />(Per person) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />X <br />BODILY INJURY $ <br />(Per arsitlan[) <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />X <br />PROPERTY DAMAGE $ <br />(Par accitlen[) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC E <br />ANY AUTO <br />AUTO ONLY: AGG $ <br />A <br />EXCESS/UMBRELLA LIABILITY <br />CUP0374T35A <br />06/17/11 <br />06/17/12 <br />EACH OCCURRENCE s2,000.000 <br />X1 OCCUR CLAIMS MADE <br />Umbrella Form <br />AGGREGATE s2,000,000 <br />$ <br />Following Form <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />A <br />WORKERS COMPEN3ATION AND <br />UB7095Y638 <br />09/01/10 <br />09/01/11 <br />XWC TORYSLI- OTH- <br />EMPLOYERS• LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT <br />1:1'2L2.000 <br />E.L. DISEASE - EA EMPLOYEE 1..O.000 <br />OFFICER/MEMBER EXCLUDED? <br />If yes, tlescreI a under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT E1 QQQ 000 <br />B <br />OTHER Professional <br />DPS9692833 <br />06/30/11 <br />06/30/12 <br />$2,000,000 per claim <br />Liability <br />$2,000,000 annl aggr. <br />Claims Made$5,000 <br />Deg. er claim <br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS AppR <br />RE: On -Call Landscape Architecture Services <br />City of Santa Ana, its officers, employees, agents, volunteers, and <br />representatives are additional insureds on General Liability policy as <br />heedy <br />required by written contract- Laura Stitt <br />-1SSiSLant. City Atlornel <br />CERTIFICATE HOLDER <br />GANGELLATION Yen Day Noti— for Non -Payment of Premwtjm <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana <br />DATE THEREOF, THE ISSUING INSURER WILL Kq pKxKMAIL _�' Q_ DAYS WRITTEN <br />Attn. City Attorney <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.*XX M K <br />20 Civic Center Plaza (M-29) <br />>eeaoartnKmnroFnnnouelcxle�elwx�aecxwxx>rao�ooanxKecwot>tem0c�txnttxelocx�cxx <br />P O Box 1988 <br />Santa Ana, CA 92702-1988 <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2001/08) 1 of 1 #M285372 TMN 0 ACORD CORPORATION 1988 <br />