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KALISKI, JOHN AIA DBA URBAN STUDIO 4 - 2011
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KALISKI, JOHN AIA DBA URBAN STUDIO 4 - 2011
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Last modified
4/29/2016 1:08:38 PM
Creation date
3/1/2011 3:10:17 PM
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Contracts
Company Name
KALISKI, JOHN AIA DBA URBAN STUDIO
Contract #
N-2011-020
Agency
PLANNING & BUILDING
Insurance Exp Date
12/13/2011
Destruction Year
2019
Notes
Amended by N-2011-020-001
Document Relationships
KALISKI, JOHN AIA DBA URBAN STUDIO 4A - 2011
(Amended By)
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\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2019
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ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/ri) <br />2 11 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Dealey, Renton & Associates <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />199 S Los Robles Ave Ste S40 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Pasadena, CA 91101 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />626 844-3070 <br />INSURED <br />Urban S'tud10 <br />3780 W±Tslalre 131Vd. , Suite 1100 <br />INSURER A: TraVe 1E'. T'S Property Casualt�Co of Am=! <br />INsuRERB:Hudson lns=a=C Company <br />------ <br />Los Angeles, CA 90010 <br />INSURER C: <br />INSURER D <br />213 383-7980 <br />INSURER E: <br />Cf]VFRCC�FC <br />HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED - <br />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 SUBaECT TO ALL THE <br />FRMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFEATEIM�ECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />A <br />GENERAL LIABILITY <br />68067081,374 <br />12/13/2010 <br />12/13/2011 <br />EACH OCCURRENCE_ $ z 0 0 0-0 0 0 _ <br />FIRE DAMAGE (Any one fire) $ 2 0.O0-00 O <br />X COMMERCIAL GENERAL LIABILITY <br />MED EXP (Any one person) $10 000 <br />CLAIMS MADE a:] OCCUR <br />PERSONAL& ADV INJURY $2 OOQ DOO <br />GENERAL AGGREGATE $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGO $4,000,000 <br />POLICY X PRO- LOC <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />BA6 7 0 8 L 7 S S <br />1-2/13/2010 <br />12/13/2011 <br />COMBINED SINGLE LIMIT $1 , 000, O O O <br />(Ea accident) <br />BODILY INJURY $ <br />(Per person) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY $ <br />(Par accident) <br />X <br />X <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />X <br />No Owned Autos <br />- <br />GARAGE LIABILITY <br />1 <br />n ^ + <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />Kv2p. <br />I <br />AUTO ONLY: AGG 5 <br />EXCESS LIABILITY <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />OCCUR CLAIMS MADE <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />A <br />WORKERS COMPENSATION AND <br />UBS276Y706 <br />1/9/2011 <br />1/9/2012 <br />X WC STIM T- I OTH- <br />EMPLOYERS' LIABILITY <br />E . EACH ACCIDENT $1 000,000 <br />E.L. DISEASE - EA EMPLOYEE $1 O O O 0 O O <br />E.L. DISEASE -POLICY LIMIT I $1 000 000 <br />B <br />OTHER <br />Professional Liability <br />AEE7242901 <br />12/11/2010 <br />12/11/2011 <br />$1,000,000 Per Claim <br />$2,000,000 Annl Aggregate <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />ity of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and <br />apresent at Ives are named as additional insured as respects general liability for claims arising from the operations o£ <br />he named insured as required per contract or agreement_ NOTE: insurance includes primary and non.contributory wording <br />er the attached endorsement, see Section H o£ the GL endorsement. <br />EVERABILITY OF INTERESTS (Per CG 00 01 10 01) <br />See Attached_.. - <br />GEF[ I IFIGA FE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATIONI D N -L f= Non-Pav-mntf Pr m <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER <br />City O£ Santna a AILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER <br />20 Civic Center NAMED TO THE LEFT. <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIV <br />ACORD 25-S (7/97) O ACORD CORPORATION 1988 <br />
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