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>aCCA76" CERTIFICATE OF LIABILITY INSURANCEDATE(MMiDD/YYYY) <br />9/3/2014 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEN. 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(Sj, AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(iesj 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 endorsements <br />PRODUCER <br />CONTACT <br />NAME: <br />Dealey.,.Renton _&AssociatesPAHONry <br />P. O. Box 10550 <br />Santa Ana CA 92711-0550 <br />_ 1 LL4 7 10 rA�lc Na :7 4-427- 1 <br />EMAIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE NAIC # <br />Y <br />INSURER A :Travalers Propei Casualty Co of / 4 <br />130N2014 <br />INSURED <br />INSURER e : r aV l r s Casualty & S.Ui Co. Ame 31194 <br />INSURER C: <br />RJM Design Group, Inc. <br />31591 Camino Capistrano <br />San Juan Capistrano CA 92.675 <br />INSURER D: <br />INSURER E: <br />INSURER F: <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 CSSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM'S, <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 />ADDL'pSUBR. <br />I SR <br />I D <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS. <br />A <br />GENERAL. LIABILITY <br />Y <br />Y <br />6805D390306 <br />130N2014 <br />/3012015 <br />EACH OCCURRENCE $2,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE JA I OCCUR <br />PREMIS TO RENTED <br />PREMISES Ea accurrencel $1,000,000 <br />MED EXP (Any one person $10„µ000 w <br />X Contractual <br />PERSONAL. S ADV INJURY $2,000,000 <br />GENERAL AGGREGATE $4,000,000 <br />Liability <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPIOP AGG $4„004,000 <br />POLICYjECT'!.X PRC- LOC <br />$ <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />AUTAUTOSAUTOS <br />NON -OWNED... <br />HIRED AUTOS AUTOS <br />BA5D394305 <br />° ! <br />�s <br />/3012014 <br />O <br />✓ <br />/30/2015 <br />O <br />. ,... <br />r^"”" <br />Ea accidentLIMIT <br />1,000,000. <br />BODILY INJURY (Per person) $ <br />--. <br />BODILY INJURY (Per accident) $ <br />PROPERTYDAMAGE$ <br />Per accident <br />UMBRELLA LIAR <br />EXCESS LIAB <br />OCCUR. <br />CLAIMS -MADE. <br />SSISH <br />1 At,to <br />Cit <br />CV <br />EACH OCCURRENCE $ <br />GGREGATE $ <br />DED.11111,11� RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS” LIABILITY Y f N <br />Y <br />'UB413OT960 <br />!30/2014... <br />13012015X. <br />WC STATU- ...0TH - <br />y11M - <br />E.L. EACH ACCIDENT $1,0100,000 <br />ANY PROPRIETORIPARTNERIEXECUTIVE [:] <br />OPPCERIMEMBER EXCLUDED? <br />N I A <br />E.L.. DISEASE -EA EMPLOYEE $1,000,000 <br />(mandatory in NHI <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $1,000,000 <br />B <br />Professional Liability <br />105991919 <br />10/112014 <br />0/112015 <br />Per Gam $1.,000,000 <br />Claims Made <br />Annual Aggr. $2,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule,, if more apace is required) <br />General Liability policy excludes claims arising 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 CANCELLATION 30 Cav/10' Dav Notice of Cancellation <br />@ 1986-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) 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.0, Box 1988 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702-1988 <br />@ 1986-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />