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Client#: 6428
<br />TATSUPART
<br />ACORDT., CERTIFICATE OF LIABILITY INSURANCEDATE iMMIOD YYYY)
<br />09/17/2014
<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(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 lieu of such endondi ment(s).
<br />PRODUCER
<br />Dealey, Renton & Associates
<br />P.O. Box 10550
<br />Santa Ana, CA 92711.0550
<br />714427.6619
<br />EppF
<br />MMIDOIVYYY
<br />PHONE714 427.6810 rrFAx 714 427-6818
<br />EaMA LEA E�L.(aV,,Ngfl,_
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURERA:Travelers Property Casualty Co
<br />25874
<br />-INSURED
<br />INSURER BXL Specialty Insurance Co.
<br />37885
<br />Tatsumi and Partnere Inc
<br />49 Discovery, Suite #120
<br />Irvine, CA 92618
<br />-- —---'—'—
<br />INSURER C:
<br />-
<br />INSURER D:
<br />X COMMERCIAL GENERAL LIABILITY
<br />_ CLAIMS -MADE lidOCCURexcludes
<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 ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING 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 />IN8R
<br />LTR
<br />TYPE OF INSURANCE
<br />SOBR—.___.._......__...__POLICY
<br />POLICYNUMBER
<br />EppF
<br />MMIDOIVYYY
<br />POLIICY EXP
<br />MMIDDNYYY
<br />—'.._._...__..._._._ _.__.
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X
<br />X
<br />68020941.400
<br />6/1712014
<br />0611712015
<br />EACH OCCURRENCE.
<br />52000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />_ CLAIMS -MADE lidOCCURexcludes
<br />General Liab.
<br />claims
<br />qENTED
<br />BG�'�i u Eemcurrence
<br />$2000069
<br />MED EXP (Any Una parson)
<br />S10000
<br />PERSONAL&AOVINJURY
<br />$2,000000
<br />arising out of
<br />GENERAL AGGREGATE
<br />54,000,000
<br />the performance
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS-COMP/OP AGO
<br />54,000000
<br />Of professional
<br />POLICY
<br />X PET El LOC
<br />service.
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />X
<br />BA4669L023
<br />6/17/2014
<br />06/171201 5
<br />EeM61NEEDISINGLE LIMIT
<br />51,090 000
<br />BODILY INJURY (Per person)
<br />5
<br />ANY AUTO
<br />_
<br />X
<br />ALL
<br />AUTOS NEO SCHEDSCHEDULED
<br />HIREDAUTOS X NON -OWNED
<br />AUTOS
<br />BODILY INJURY (Per occident)
<br />PftOPEFITV DAMA���
<br />$
<br />$ �'
<br />A
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />CUP0374T35A
<br />06/1712014061171201
<br />E
<br />EACH OCCURRENCE
<br />s2009000
<br />AGGREGATE
<br />Q2,000,000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />Does not Include
<br />DED RETENTIONS
<br />$
<br />Prof I. Liab.
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITYTORY
<br />ANY PROPRIETORIPARTNERIEXECUTIVE�
<br />OFFICERMIEMBER EXCLUDE N
<br />(Mandatory In NN)
<br />N1
<br />X
<br />U67096Y638
<br />09101/2014
<br />09/01/201
<br />X WCSTATIH OTH.
<br />LIMITS ER
<br />E.L. EACH ACCIDENT
<br />51000000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000_,000
<br />OIf E aGdesc be undo,RIPTION OF OPERATIONS helow
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000 J
<br />8
<br />Prof) Liab.
<br />DPS9717259
<br />06130/2014
<br />06/30/201 t
<br />$2,000,000 per claim
<br />Claims Made
<br />$2,000,000 annl aggr.
<br />Full Prior Acts
<br />$5,000 Ded. per claim
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace Is required)
<br />30 Day Notice of Cancellation/10 Day for Non -Payment of Premium.
<br />RE: On -Call Landscape Architecture Services APP VED S'T' FORM
<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) Y�
<br />City of Santa Ana
<br />Executive Director of the Public Works Agency
<br />20 Civic Center Plaza (M-36)
<br />P 0 Box 1988
<br />Santa Ana, CA 92702-1988
<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 />AUTHORIZED REPRE8ENTATIVK
<br />I/yw
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br />#S1105544/M1105527 TMN /
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