RBF CONSULTING 2 - 2012 - Laserfiche WebLink

Home Browse Search

CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) F 02/08/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER AOn Risk SerVlCeS Central, Inc. Pittsburgh PA office Dominion Tower, 10th Floor APPROVED AS TO FOR 625 Liberty Avenue / CONTACT PHONE. (866) 283 -7122 FAX (847) 953 -5390 C. No. Ext): AIC. No.): -MA,L ADDRESS: Pittsburgh PA 15222 -3110 USA TB INSURER(S) AFFORDING COVERAGE NAIC # INSURED �(� 1� RBF Consulting (j-� i Po BOX 57057 �"Rr Irvine CA 92619 -7057 USA O' O E City Attorney INSURER A: Liberty Mutual Fire Ins CO 23035 B; Liberty Insurance Corporation 42404 INSURER C: Lloyds syndicate No. 2623 INSURER D: 1128623 ' PREMISES AMA Ea occurrence N D INSURER E: MED EXP (Any one person) $5,000 INSURER F: X Contractual COVERAGES CERTIFICATE NUMBER: 570045253044 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE IN R WVO POLICY NUMBER IMMIDDIVYYYJ LIMITS GENERAL LIABILITY TB EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR ' PREMISES AMA Ea occurrence N D $1,000,000 MED EXP (Any one person) $5,000 X Contractual PERSONAL & ADV INJURY $2,000,000 X BFPD, XCU I GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $4,000,000 POLICY X PRO- X LOC A AUTOMOBILE LIABILITY AS - 81- 004145 -7 1 06 30 2011 06/30/2012 COMBINED SINGLE LIMIT a accident) $1,000,000 BODILY INJURY ( Per person) x ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident X HIRED AUTOS X NON -OWNED AUTOS B X UMBRELLA TH7681004145681 06/30 201106/30/2012 EACH OCCURRENCE $10,000,000 L EXCESS LIAR F.00C,.UR LAS -MADE AGGREGATE $10,000,000 DED RETENTION 510,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN AN Y PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE (Mandatory In NH) Ii yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT C E&O- ProfLiabPri QK1102675 Professional & Pollution SIR applies per policy ter 06/30/2011 s & co 06/30/2012 ions Per Claim Aggregate $5,000,000 $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Santa Ana, its officers, agents, volunteers, employees and representatives are included as Additional Insured on the General Liability policy as required by written contract. Coverage afforded under the General Liability policy is Primary. Separation of Insured clause applies under the General Liability policy. Form LIM99010511 - Notice of Cancellation to Third Parties - 30 day is attached to the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana AUTHORIZED REPRESENTATIVE c/o Clerk of the Council 20 Civic center Plaza Po Box 1988 Santa Ana CA 92702 USA ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD `m c m m 0 S ►t N O N O Z m V d O