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RJMDESI-01
<br />"Ic" CERTIFICATE OF LIABILITY INSURANCE DATE 10/17/201 YY)
<br />�--�''� 10/17/2017
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License # OE67768 % CONTACT Ali Smith
<br />1 NAME:
<br />IOA Insurance Services PHONE FAX
<br />4370 La Jolla Village Drive (A/C No, Ext)No):(619) 574
<br />_ (619) 788-5795 50206 (A/C, -6288
<br />E-MAIL Ali .Smith@loausa com
<br />Suite 600 ADDRESS:___
<br />San Diego, CA 92122 -- -
<br />INSURED
<br />RJM Design Group, Inc.
<br />31591 Camino Capistrano
<br />San Juan Capistrano, CA 92675
<br />INSURER A : RLI Insurance C
<br />INSURERB: Arch Insurance
<br />INSURER C:
<br />E:
<br />F:
<br />rnAIPPAMPQ CGGTIVIL`ATG NII INA9:11=0- DC\/ICIPMI All IRAQCO.
<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
<br />THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
<br />BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE
<br />BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR TYPE OF INSURANCE ADDDL SUER POLICY NUMBER
<br />POLICY EFF PMMIDDIYYYYI IOLICY EXP LIMITS
<br />A
<br />X 1. COMMERCIAL GENERAL LIABILITY2,000,000
<br />EACH OCCURRENCE $
<br />1 CLAIMS -MADE X OCCUR X PSB0007263
<br />09/30/2017 09/30/2018 DAMAGES Ea GE TO RENTED
<br />TE ante) $
<br />1,000'000
<br />X Cont Llab/SeV of Int
<br />10,000
<br />..... _
<br />MED -EXP (Any one person)_ $
<br />__._.
<br />PERSONAL 8 ADV INJURY $
<br />-- —.....
<br />2,000,000
<br />1 GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE. $ _
<br />------ --------
<br />4,000,000
<br />POLICY X l JET LOC
<br />PRODUCTS - COMP/OP AGG $
<br />4,000,000
<br />Deductible
<br />0
<br />OTHER:
<br />$
<br />A
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />1,000,000
<br />(Ea accident) $
<br />ANY AUTO PSA0002412
<br />X
<br />09/30/2017 09/30!2018 BODILY INJURY (Per person) $
<br />I OWNED SCHEDULED
<br />AUTOS ONLY ; AUTNOS
<br />BODILY INJURY (Per, accident) $
<br />_
<br />Ep
<br />X AUTOS ONLY X.._ AUOTOS ONtJLY
<br />PROPERTY AMAGE
<br />No Co. Ownedaccident
<br />X f Autos
<br />$
<br />A
<br />X UMBRELLA LIAB OCCUREACH
<br />OCCURRENCE $
<br />1,000,000
<br />EXCESS LIAB CLAIMS -MADE PSE0003628
<br />09/30/2017 09/30/2018 AGGREGATE $
<br />1,000,000
<br />DEDI' RETENTION $
<br />$ -
<br />...
<br />A
<br />WORKERS COMPENSATIONX
<br />AND EMPLOYERS' LIABILITY
<br />PER OTH-
<br />.-STATUTE '.. ER ,.. _.
<br />Y / N
<br />ANY PROPRIETOR/PARTNER ExEcunvE X ',PSW0004066
<br />09/30/2017 09/30/2018
<br />E.L. EACH ACCIDENT $
<br />1,000,000
<br />OFFICER/MEMBER EXCLUDED? NIA
<br />-
<br />(Mandatory in NH)E.L.DISEASE
<br />._
<br />- EA EMPLOYEE $
<br />1,000,000
<br />yes, describe under
<br />'. DESCRIPTION OF OPERATIONS below
<br />D
<br />' � E.L. DISEASE -POLICY LIMIT $
<br />1�000,000
<br />B
<br />!:Prof Liab/Clms Made PAAEP0031100
<br />10/01/2017', 10/01/2018 Per Claim
<br />2,000,000
<br />B
<br />Ded.: $25k Per Claim PAAEP0031100
<br />10/01/2017 10/01/2018 ;Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Re: A-2009-023 and A-2014-223-03
<br />The City of Santa Ana, its officers, employees and representatives are Additional Insureds with respect to General and Auto Liability per the attached
<br />endorsements as required by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to Workers' Compensation.
<br />30 Days Notice of Cancellation with 10 pays Notice for Non -Payment of Premium in accordance with the policy pr isions.
<br />REVIEWEC) BY: EUNIC,E HEREDIA (PG � OF
<br />)
<br />City of Santa Ana
<br />Attn: Susie Furjanic
<br />PO Box 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 />ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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