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CAPOUYA, LYNN-2009
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CAPOUYA, LYNN-2009
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Last modified
11/10/2015 4:55:08 PM
Creation date
8/11/2009 3:01:17 PM
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Contracts
Company Name
CAPOUYA, LYNN
Contract #
A-2009-024
Agency
Public Works
Council Approval Date
3/2/2009
Insurance Exp Date
7/10/2016
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ACORD,M CERTIFICATE OF - - INSURANCE Date (MM /DD/YYYI� <br />o�i2oi� o <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Leatzow Insurance <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2301 W. 22nd Street Suite 208 <br />ALTER THE COVERAGE AFFORDED BY THE POLICY BELOW. <br />COMPANIES AFFORDING COVERAGE <br />p <br />p Ur, I I PM 5' 54 <br />COMPANY <br />Oak Brook, IL 60523 <br />A New Hampshire Insurance Company <br />INSURED <br />'CiL <br />COMPANY <br />Lynn Capouya, Inca CLEP.t :. <br />s <br />COMPANY <br />17992 Mitchell South, #110 <br />Irvine, CA 92614 <br />c <br />COMPANY <br />D <br />;COVERAGES <br />THIS IS TO CERTIFY 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 NAY 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 />CO <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE (MM /DD /YY) <br />DATE (MM /DD /YY) <br />LIMITS <br />GENERAL LIABILITY <br />BODILY INJURY OCC <br />$ <br />COMPREHENSIVE FORM <br />BODILY INJURY AGG <br />$ <br />PREMISES /OPERATIONS <br />PROPERTY DAMAGE OCC <br />$ <br />UNDERGROUND <br />PROPERTY DAMAGE AGG <br />$ <br />EXPLOSION COLLAPSE HAZARD <br />PRODUCTS /COPMLETED OPER <br />DOES NOT APPLY <br />BI & PD COMBINED OCC <br />$ <br />BI & PD COMBINED AGG <br />$ <br />CONTRACTUAL <br />INDEPENDENT CONTRACTORS <br />PERSONAL INJURY AGG <br />$ <br />BROAD FORM PROPERTY DAMAGE <br />PERSONAL INJURY <br />S To <br />AUTOMOBILE LIABILITY <br />P i <br />BODILY INJURY <br />r Person) <br />$ <br />ANY AUTO <br />BODILY INJURY <br />(Per Accident) <br />$ <br />ALL OWNED AUTOS(Private Pass) <br />06 y <br />Sh d <br />ALL OWNED AUTOS <br />DOES NOT APPLY <br />La uta S <br />itt neY <br />AttOT <br />(Other than Private Passenger) <br />-t <br />,ty <br />PROPERTY DAMAGE <br />$ <br />HIRED AUTOS <br />�SS1Stan <br />BODILY INJURY <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />$ <br />GARAGE LIABILITY <br />COMBINED <br />EXCESS LIABILITY <br />EACH OCCURENCE <br />Is <br />AGGREGATE <br />$ <br />UMBRELLA FORM <br />DOES NOT APPLY <br />OTHER THAN UMBRELLA FORM <br />$ <br />WORKERS COMPENSATION <br />WC STATU- <br />TORY LIMITS <br />OTH- <br />ER <br />AND EMPLOYERS' LIABILITY <br />EL EACH ACCIDENT <br />$ <br />RIETOR/ <br />THE PROPS INCL <br />DOES NOT APPLY <br />EL DISEASE - POLICY LIMIT <br />$ <br />PAR TNER /EXECUTIVE <br />OFFICERS ARE: EXCL <br />e <br />EL DISEASE - EA EMPLOYEE <br />$ <br />OTHER <br />2,000,000 each claim <br />A <br />Professional <br />011104461 <br />7/30/2010 <br />7/30/2011 <br />2,000,000 aggregate <br />Liability <br />DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /SPECIAL ITEMS <br />Re: On -Call Landscape Architectural Services <br />HOLDER CERTIFICATE <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Public Works Agency M -36 <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />Attn: Mind L <br />Mindy y <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF <br />P.O. Box 1988 <br />ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />�I(I LEATZOW INSURANCE <br />. <br />CORPORATION <br />
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