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Last modified
8/14/2018 9:53:52 AM
Creation date
7/31/2009 8:30:55 AM
Metadata
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Template:
Contracts
Company Name
TATSUMI AND PARTNERS
Contract #
A-2009-022
Agency
Planning & Building
Council Approval Date
3/2/2009
Expiration Date
9/1/2010
Insurance Exp Date
9/1/2019
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Client#: 6428 <br />TATSUPART <br />ACORD, CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />07/05/2012 ' <br />PRODUCER <br />Dealey, Renton & Associates <br />P. O. Box 10550 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <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 />NSR <br />714 427-6810 n,� % i, <br />,_� ,, 1 � <br />fiV�1}R AFFORDING COVERAGE NAIC # <br />INSURED <br />Tatsumi and Partners Inc , , <br />49 Discovery, Suite #120 t <br />Irvine, CA 92618 <br />INSURER A: Travelers Property Casualty Co 25674 <br />W$U r L Specialty Insurance Co. <br />INSUIk <br />INSURER D: <br />INSURER E: <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 REQUIREMENT, 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 />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM DD <br />POLICY EXPIRATION <br />AT MM /DD <br />LIMITS <br />A <br />GENERAL LIABILITY <br />68020941-400 <br />06/17/12 <br />06/17/13 <br />EACH OCCURRENCE $2.000.000 <br />MERCIAL GENERAL LIABILITY <br />General liab <br />DAMAGE TO RENTED $2,000,000 <br />PREMISES <br />PCOM <br />CLA!M2 MADE 5i! l•rCUR <br />-excludes _I:i?m¢ <br />MED EXP (Any one person) $10-000 <br />PERSONAL & ADV INJURY $2.000.000 <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 P"_LOC <br />JECT <br />services <br />A <br />AUTOMOBILE <br />LIABILITY <br />BA4669LO23 <br />06/17/12 <br />06/17/13 <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />(Ea accident) $1,000,000 <br />BODILY INJURY $ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />(Per person) <br />X <br />HIRED AUTOS <br />BODILY INJURY $ <br />X <br />NON -OWNED AUTOS <br />(Per accident) <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: AGG $ <br />A <br />EXCESS/UMBRELLA LIABILITY <br />CUP0374T35A <br />06/17/12 <br />06/17/13 <br />EACH OCCURRENCE s2,000,000 <br />X1 OCCUR FICLAIMS MADE <br />Umbrella Form <br />AGGREGATE s2,000,000 <br />$ <br />Following Form <br />$ <br />DEDUCTIBLE <br />Excludes Prof 1. <br />$ <br />RETENTION $ <br />Liability <br />A <br />WORKERS COMPENSATION AND <br />UB7095Y638 <br />09/01/11 <br />09/01/12 <br />X WC STATU- OTH- <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDFNI a i GOO OOO <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. DISEASE - EA EMPLOYEE $1,000,000 <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT I $1 OOO 000 <br />SPECIAL PROVISIONS below <br />B <br />OTHER Prof I. Liab <br />DPS9700609 <br />06/30/12 <br />06/30/13 <br />$2,000,000 per claim <br />Claims Made <br />$2,000,000 annl aggr. <br />Full Prior Acts <br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <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 />(See Attached Descriptions) <br />City of Santa Ana <br />Clerk of the City Council <br />20 Civic Center Plaza (M-30) <br />P O Box 1988 <br />Santa Ana, CA 92702-1988 <br />Tor <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ROWOMRXIL MAIL -In DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,J(T�j (1( <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2001/08) 1 of 2 #S332160/M332135 CAB <br />© ACORD CORPORATION -1988 <br />
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