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CIVIL SOURCE, INC. (2) - 2012
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CIVIL SOURCE, INC. (2) - 2012
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Last modified
11/10/2015 4:58:06 PM
Creation date
9/13/2012 3:37:48 PM
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Contracts
Company Name
CIVIL SOURCE, INC.
Contract #
N-2012-104
Agency
Public Works
Insurance Exp Date
7/20/2013
Destruction Year
2020
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r- ue.,Ix• � aria <br />CIVII SAAR <br />ACORO... CERTIFICATE OF LIABILITY <br />INSURANCE oiiz3rzoi2 <br />PRODUCER <br />Deatey, Renton & Associates <br />P. O. Box 10550 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THi3 CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW - <br />Sante Ana, CA 82711 -0550 <br />N <br />TYPE OF INSURANCE <br />714 427 -fSB1 O <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />INSURERA Travelers Propert Casualty Co <br />25674 <br />Clvll Source, Inc. <br />INSURER e: XL Specialty Insurance Co. <br />37$85 <br />9930 Research Drive <br />Irvine, CA 92618 <br />INSURER C: <br />EACH OCCURRENCE <br />INSURER O: <br />DAMAGE TO RENTED <br />INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR COND)TION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORD EO BY THE POLICIES DESCRIBED HEREIN IS BUBJECT TO ALL THE TERMS, EXCLUSIONS ANO COND]TIONS OF 8UCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE 6EEN REDUCED BY PAID CLAIMS. <br />lTR <br />N <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />PDA E PRA 1 <br />LIMITS <br />1717 4th Street, Suite 250 <br />A <br />IQ) 001K1[ RRIlFfWiItRAC[ AR1KIRR) 1700XA/ IXRAW% A[ ANRRQ CMAC�06xiLRAM1iRDL06J0lCCX% <br />GENERAL LIABILITY <br />$$Q2$1QL75$ <br />Q7/2Q/12 <br />Q7/2Q/13 <br />EACH OCCURRENCE <br />52 QQQ QQQ <br />DAMAGE TO RENTED <br />51 QQQ QQQ <br />X COMMERCIAL GENERAL DABILITY <br />GBnerBl Liab. <br />CLAIMS MADE �OCCVR <br />eXCIUde$ CIeImB <br />MEO E %P (Myona person <br />51Q QQQ <br />PERSONALBAOVINJURY <br />52 QQQ QQQ <br />X Ltd Contractual Llab <br />arising OUt Of <br />GENERAL AGGREGATE <br />54 QQQ QQQ <br />the performance <br />GE N'L AGGREGATE LIMIT APPLIES PER: <br />PRODVCTS- COMPJOP AGG <br />54 QQQ QQQ <br />Of profe88lOnel <br />POLICY PRO- LOC <br />$erylCeB. <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />BA4592L377 <br />07/20/12 <br />07/20/13 <br />GOMBINE081NGLE LIMIT <br />(Ea ecddenp <br />51 QQQ QQQ <br />, , <br />BOOlLY INJURY <br />rParaon) <br />S <br />ALL OWNED AUTOS <br />SCHEDULED AVT09 <br />A T-, gT <br />�,/L�I /�y <br />�T �� � -�.1�� <br />X <br />6001LY INJURY <br />(Per sodden!) <br />S <br />HIRED AVTOS <br />NON -0WNED AVT09 <br />,f-sl <br />x <br />Q <br />Laur:J SLiI <br />t- <br />�� Cam" <br />_t cdy <br />< Pe, accidanlDAMAG£ <br />S <br />pARAOE LIABILITY <br />�SSIS CSRL CIC <br />LLOTTle�/ <br />AUTO ONLY -EA ACCIDENT <br />5 <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />S <br />AVTO ONLY: A06 <br />A <br />E %CESSNMBRELLA LU\BILITY <br />CUP6772Y251 <br />Q7/2Q/12 <br />Q7/2Q/13 <br />EACH OCCURRENCE <br />51 QQQ QQQ <br />X OCCUR � CLAIMS MADE <br />DOB$ not Include <br />AGGREGATE <br />51 QQQ QQQ <br />s <br />Professional <br />s <br />DeoucnaLE <br />Liability <br />S <br />RETENTION 5 <br />A <br />WORKERS COMPENSATION AND <br />UB6771 Y51$ <br />Q7/2Q/12 <br />Q7/2Q/13 <br />X WC STATU- OTH- <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNE WE %ECUTIVE <br />OFFICERR.lE/.rBER EXCLUDED? <br />E.L. EACH ACCIDENT <br />S1 QQQ QQQ <br />E.L. DISEASE -EA EMPLOYEE <br />$1 QQQ QQQ <br />1! es, dasuiba urMOr <br />SPECIAL PROVISION bebw <br />EL DISEASE- POLICY LIMIT <br />$1 QQQ QQQ <br />B <br />OTHER professional <br />DPR9700726 <br />07/20/12 <br />07/20/13 <br />52,000,000 per claim <br />Llablllfy <br />52,000,000 annl aggr. <br />Claim$ Made <br />$2Q 000 Ded. er claim <br />OEBCRI PTION OF OPERATIONS /LOCATIONS / V ENICLES !EXCLUSIONS AD OED BY ENDORSEMENT /SPECIAL PROV1810H9 <br />Re: All Operations as pertains to named Insured. <br />City of Santa Monica, Its officers, officials, employees and volunteers <br />are additional Inured on general and automobile Ilablllly as required by <br />written contract. <br />(Sea Attached Descriptions) <br />GERTI FIGATE HOLDER <br />CAN:[. -E ELATION T V Ua B TOr IVOn -Ya mBnT <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAHC ELLED BEFORE THE E %PIRATION <br />city of3antaMonlca <br />DATE THEREOF, THEISSUINOINBURERWILLAM {iEIV[ARR9iMA1L �_ DAYS WRITTEN <br />Civil E ng 8. Arch Srvcs <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ylARRMINAP000QAQC�0l4tK <br />1717 4th Street, Suite 250 <br />IQ) 001K1[ RRIlFfWiItRAC[ AR1KIRR) 1700XA/ IXRAW% A[ ANRRQ CMAC�06xiLRAM1iRDL06J0lCCX% <br />Santa Monica, CA 90401 <br />Rr®RERRG[i6XRJEX <br />HO� RIZEQ REPRESENTATIVE <br />ACORD 25 (2001!08) 1 of 2 //3345255lM345222 TMN o ACORD CORPORATION 198$ <br />
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