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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />/207M'°°m"Y'
<br />9/33(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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION 1$ WAIVED, subject to
<br />the terns 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 />CONTAG
<br />NAME:
<br />Dealay, Renton & Associates
<br />P. 0. Box 10550
<br />Santa Ana CA 92711-0550
<br />_
<br />PHONE .t) 1/ 4-427.6810 aC N x714-
<br />E -MAR
<br />8DPRESS;
<br />INSURERP) AFFORDING COVERAGE NAIC N
<br />130/2014
<br />INSURER A -Tr Propedy Casually Co of A aKZA—
<br />EACH OCCURRENCE $2,000,000
<br />INSUR90
<br />INSURERB.Travalers Casualty & Suretv CO Ame 31194
<br />INSURER C:
<br />RJM Design Group, Inc,
<br />INSURER D:
<br />31591 Camino Capistrano
<br />San Juan Capistrano CA 92675
<br />— — —
<br />INSURER E
<br />INSURER P:
<br />COVERAGES CERTIFICATE NUMBER: 160437120 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE. BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />ILTR
<br />TYPE OF INSURANCE
<br />I$
<br />INSRi
<br />VO
<br />POLICY NUMBER
<br />POLICYEPP
<br />'MMIDOR'YYY
<br />POLICY EXP
<br />MMI
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />Y
<br />Y
<br />38O6D39D305
<br />130/2014
<br />/3012015
<br />EACH OCCURRENCE $2,000,000
<br />x COMMERCIAI_GENERALLIABILITY
<br />_
<br />PREMISES (Ee moognercel $1,000,000
<br />CLAIMS -MADE IT] OCCUR
<br />MEDEXP An one arson $10,000
<br />PERSONAL B ADV INJURY $2,000,000
<br />X Contractual
<br />Liability
<br />GENERALAGGREGATE $4000,000
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS-COMPIOPAGG $4,000,000
<br />$
<br />POLICY X PRO- LDC
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />BA50394305
<br />13012014
<br />W1^
<br />313012015
<br />roroT�ppCOMBINED
<br />OTLLY}f
<br />SINGLE UMn
<br />Eeacclde $1000_000
<br />BODILY INJURY (Per person) $
<br />x
<br />ALLOWNEO SCHEDULE D
<br />AUTOS AUTOS
<br />NON-OWNED
<br />HIREDAUTOS x AUTOS
<br />x+®�ll✓
<br />.k1r-�
<br />4.,.
<br />BODILY INJURY $
<br />PRO PE MT YDAMAGEaccidan0
<br />Per accltlent $
<br />$
<br />Y j
<br />UMBRELLA LIAR
<br />EXCESS LIAR
<br />OCCUR
<br />CLAIMS -MADE
<br />LISA'
<br />Assistan
<br />�Ity ptto
<br />ney
<br />(Jfjy
<br />Lf
<br />EACH OCCURRENCE $
<br />AGGREGATE $
<br />OED RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y N
<br />ANY PROPRIErOMPARTNER)EXECUTIVE❑
<br />y
<br />Ur8413OT960
<br />Df3012014
<br />13012015
<br />X WC STATU- OTT
<br />Ony
<br />E.L. EACH ACCIDENT $1,000,000
<br />OPFICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />NIA
<br />E.L. DISEASE -EA EMPLOYEE $1,000,000
<br />If yes, describe under
<br />DE SCMPTION OF OPERATIONS below
<br />E.L DISEASE -POLICY LIMIT $1000,000
<br />B
<br />Professional Liability
<br />Claims Made
<br />105991919
<br />10/112014
<br />0/112015
<br />_
<br />Per Claim$1,000,000
<br />Annual Aggr. 32,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101,AddRional Remarks Schedule, If more space is required)
<br />General Liability policy excludes Claims arlsing out of the performance of professional services.
<br />Re: On -Call Services - City of Santa Ana, CA.
<br />The City of Santa Ana, its officers, employees and representatives are Additional Insured as respects to General Liability coverage as
<br />required by written contract.
<br />Primary and Non -Contributory applies to General Liability as required by written contract. Waiver of Subrogation for Work Comp Is included
<br />as required by written contract,
<br />See Attached...
<br />CERTIFICATE HOLDER CANCELLATION30 Devil Dav Notice of Cancellation
<br />©1988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Marilyn Boothe
<br />P.O. Box 1988
<br />Santa Ana, CA 92702-1988
<br />UTHORIZED REPRESENTATIVE
<br />©1988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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