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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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ACORD- CERTIFICATE OF LIABILITY INSURANCE <br />I8/1412012 <br />2 M <br />PRODUCER <br />PRODUCER <br />Dealey, Renton & Associates <br />P. O. BOX 10550 <br />THIS CERTIFICATE IS ISSUED ASA 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 />TY►E OF INSURANCE <br />714 427-6810 <br />POLICY EFFECTIVE <br />INSURERS AFFORDING COVERAGE NAIC S <br />INSURED <br />A <br />INSURER A: Travelers ProDerty Casualtv CO 25674 <br />Tatsumi and Partners Inc. <br />49 Discovery, Suite #120 <br />Irvine, CA 92618 <br />I INSURER B XL Specialty Insurance Co. 1 37885 1 <br />INSURER D: <br />INSURER E: <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 />INSR L <br />TY►E OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />A <br />GENERAL "ABILITY <br />6802094L400 <br />06/17/12 <br />06/17/13 <br />FACH OCCURRENCE s2,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />General Liab- <br />DAMAGE TO RENTED s2,000,000 <br />CLAIMS MADE 51OCCUR <br />excludes claims <br />MED EXP (Any we person) $1 O OOO <br />PERSONAL 6 ADV INJURY s2.000.000 <br />arising out of <br />GENERAL AGGREGATE $4.000,000 <br />the performance <br />GENL AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG S4,000,000 <br />Of professional <br />POLICY PRO LOC <br />S@NIG@s. <br />A <br />AUTOMOBILE <br />LIABILITY <br />BA4669L023 <br />06/17/12 <br />06/17/13 <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />(Ea accident) S1,000,000 <br />BODILY INJURY S <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />(Per person) <br />BODILY INJURY $ <br />X <br />HIRED AUTOS <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 S <br />- <br />'ANY'AUTO-- ', `_ _' <br />AUTO ONLY <br />AGG S <br />A <br />EXCESS/UMBRELLA LIABILITY <br />CUP0374T35A <br />06/17/12 <br />06/17/13 <br />EACH OCCURRENCE - s2 000 OOO <br />X OCCUR F7 CLAIMS MADE <br />Umbrella Form <br />AGGREGATE s2,000,000 <br />$ <br />Following Form <br />$ <br />DEDUCTIBLE <br />Excluding ProYl <br />$ <br />RETENTION $ <br />Liability <br />A <br />WORKERS COMPENSATION AND <br />US7095Y638 <br />09/01/12 <br />09/01/13 <br />X WCSTATU- OTH- _ <br />EMPLOYERS' LIABILITY. <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />- <br />E.L. EACH ACCIDENT s1 000'000 <br />E.L. DISEASE - EA EMPLOYEE $1,000,000 <br />OFFICERIMEMBER EXCLUDED? <br />"yes, tlesuibe antler _ <br />SP CIALPROVISIONS below <br />E -L- DISEASE -POLICY LIMIT $1,000,000 <br />B <br />OTHER Profl Liab. <br />DPS9700609 <br />06/30/12 <br />06/30113 <br />$2,000,000 per claim <br />Claims Made <br />$2,000,000 annl ag9r. <br />Full Prior Acts <br />$5,000 Dad per claim <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />RE: On -Call Landscape Architecture Services cou.Iu;)� �,u;gscssb <br />City of Santa Ana, its officers, employees, agents, volunteers, and nIS eJne-T <br />insureds <br />representatives are additional on General Liability policy as <br />required by written Contract. (sal) <br />(See Attached Descriptions) <br />T <br />City of Santa Ana <br />Attn: City Attorney <br />20 Civic Center Plaza (M-29) <br />P O Box 1988 <br />Santa Ana, CA 92702-1988 <br />ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TME EXPIRATION <br />EREOF, THE ISSUING INSURER WILL siIiiiiiielIfelift MAIL 3Q DAYSWRITTEN <br />'O THE CERTIFICATE HOLDER NAMED TO THE LEFT.Swz IC®OOeOONRY <br />REPRESENTATIVE <br />.�Vnw � Rcvulivel 1 of 2 XS358515/M358363 TMN 0 ACORD CORPORATION 1988 <br />
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