|
ACC>RDr CERTIFICATE OF LIABILITY INSURANCE
<br />tl*�
<br />DATE(MM/DD/YYYY)
<br />1 9/12/2017
<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 12675
<br />Oakland, CA 94604-2675
<br />CONTACT
<br />Luz Dinsa
<br />PHONE FAX
<br />W No ext . 626 844-3070 (A/C No):
<br />MES., Idinsay@dealeyrenton.com
<br />License #0020739
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA:Travelers Casualty & Surety Co. Arne
<br />31194
<br />6802J145912
<br />INSURED TATSUPART
<br />INSURER a :Travelers Property Casualty Co of A
<br />25674
<br />Tatsumi and Partners Inc
<br />49 Discovery, Suite #120
<br />Irvine CA 92618
<br />_
<br />INSURERc:American Automobile Ins. Co.
<br />21849
<br />INSURER D:Travelers Indemnity Co. of Connecti
<br />25682
<br />INSURER E:
<br />INSURER F:
<br />X XCU
<br />PERSONAL & ADV INJURY $2,000,000
<br />COVERAGES CERTIFICATE NUMBER! 612526720 RG\/ICIAtU All IMDCD.
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />VJVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />B
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X� OCCUR
<br />Y
<br />Y
<br />6802J145912
<br />6/17/2017
<br />6/17/2018
<br />EACH OCCURRENCE $2,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence $2,000,000
<br />MED EXP (Any one person) $10,000
<br />X Contractual Liab
<br />X XCU
<br />PERSONAL & ADV INJURY $2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $4,000,000
<br />PRODUCTS - COMP/OP AGG $4,000,000
<br />.,.,,...,..._.__._._.....,.,.._.._.__ _-..._.._,. .....
<br />POLICY X❑ JE O LOC
<br />OTHER:
<br />$
<br />D
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />BA4669LO23
<br />6/17/2017
<br />6/17/2016
<br />COME31NED
<br />enQ, INCL $1,000,000
<br />ANY AUTO
<br />BODILY INJURY (Per person)AUTOS
<br />NED AUTOSULEDBODILY
<br />INJURY (Per accident) $
<br />IX
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />OP R DAMAGE
<br />Per accident $
<br />B
<br />X
<br />UMBRELLA LIABX
<br />OCCUR
<br />CUP0374T35A
<br />6/17/2017
<br />6/17/2018
<br />EACH OCCURRENCE $2,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE $2,000,000
<br />DED I RETENTION $
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />N / A
<br />y
<br />WZP81041618
<br />9/1/2017
<br />9/1/2018—X-7—ER
<br />OTH-
<br />TATUTE ER
<br />E.L. EACH ACCIDENT $1,000,000
<br />E.L. DISEASE - EA EMPLOYE $1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT $1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />A
<br />Professional Liability
<br />106325913
<br />6/30/2017
<br />6/30/2018
<br />$2,000,000 each claim
<br />$2,000,000 Aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />RE: On -Call Landscape Architecture Services City of Santa Ana, its officers, employees, agents, volunteers, and representatives are
<br />additional insurcriS On G'ener_nl, I lahIIIty policy as e.nMuir-.d by written t—M/--;Nvn
<br />l0011
<br />y
<br />REVIEWED BY: EUNICE HEREDIA (PG
<br />"�^••• •`"^•'— ••�+`-'�•�•� V-I119lrGLLN1IV IY .V vay ivvu%,C UI %JC111GCI1C1uVII
<br />City of Santa Ana
<br />20 Civic Center Plaza (M-36), P O 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 REPRESENTATIVE
<br />F
<br />G 1Vt5t5-ZU14 ACVKD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
|