|
RINCCON -01 MANAWILM
<br />A � CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDUNYYY)
<br />I I YPE OF INSURANCE
<br />11/18/2014
<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 be endorsed. If SUBROGATION IS WAIVED, subjectto
<br />the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER License ff OE67768
<br />Legends Environmental Ins. Services
<br />130 Venda, Suite 250
<br />Aliso Viejo, CA 92656
<br />o'- !J�
<br />_
<br />CONTACT Ryan Jacques
<br />q Ues
<br />'a q'
<br />N' Ax
<br />_(?ic„tLn,_E_x0; (800) 992 -6999 A/C No ; B00 999 -3987
<br />E-MAIL
<br />E-MAIL ADDRESS, Ryan.Jacques IGausa.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC N
<br />INSURER A: Crum $ Forster Specialty Insurance Company
<br />44520
<br />INSURED
<br />INSURER B;
<br />EACH OCCURRENCE
<br />E'fG pENTED —"
<br />MEMISE3 Ee pccurrebce
<br />INSURER C:
<br />Rlncon Consultants, Inc.
<br />INSURER O:
<br />$
<br />210 N Ashwood Ave
<br />Ventura, CA 93033
<br />INSURER E:
<br />Transportation Pol."
<br />NSURERF:
<br />COVHHAGES CERTIFICATE NUMBER: REVISION NUMBER'
<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 THIS
<br />CERTIFICATE MAY 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 />_
<br />INS,
<br />LT
<br />I I YPE OF INSURANCE
<br />ADDL
<br />So BR
<br />POLICY NUMBER
<br />POLIC EFF
<br />MMIDD
<br />POLI EXP
<br />MMIDDIYYV
<br />LIMBS
<br />A
<br />X
<br />COMMERCNU GENERA44lABIGTY
<br />CLAIMS -MADE 1K OCCUR
<br />Pollution Liability
<br />X
<br />EPK- 105397
<br />09/222014
<br />0922/2D16°
<br />EACH OCCURRENCE
<br />E'fG pENTED —"
<br />MEMISE3 Ee pccurrebce
<br />§ 3,000,000
<br />5 50,000
<br />X
<br />MED EXP (Any one parson)
<br />$
<br />XJ
<br />Transportation Pol."
<br />PERSONAL B ADV INJURY
<br />$ 3,000,000
<br />AGGREGATE LIMIT APPLIES PER;
<br />POLICY LOG PRO-
<br />EGT
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />GEN'L
<br />X
<br />PRODUCTS - COMPIOP AGO
<br />$ 4,000,000
<br />Transp. Poll.*
<br />$ 1,000,000
<br />OTHER: _
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />§
<br />BODILY INJURY (Par parson)
<br />§
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BOOILYINJURY Pet eccidenl
<br />1 1
<br />$
<br />_
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PR OPERTYDAMAG
<br />parncdd -0
<br />- -' –'
<br />$
<br />$
<br />UMBRELLA LIAII
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />§ 5,000,000
<br />A
<br />X
<br />EXCF.SSLIAB
<br />CLAIMS -MADE
<br />X
<br />EFX- 101817
<br />091222014
<br />09/2212015
<br />rAGGREGATE
<br />$ 5,000,000
<br />DEB I X RETENTION$ 10,000
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNEWEXECUTIVE
<br />OFFICERWEMBER EXCLUDED? ❑
<br />NIA
<br />STATUTE ER
<br />EL. EACH ACCIDENT
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />--
<br />5
<br />(Mmml Imy In NH)
<br />Use, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />- ......._
<br />S
<br />A
<br />Professional Liab.`
<br />EPK- 105397
<br />0912212014
<br />'0912212016
<br />Included in Above OL
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more sprees, Is requited)
<br />-The City of Santa Ana, Its officers, employees, . agents and volunteers are included as additional Insureds with regard to liability and defense of suits arising
<br />from work performed by or behalf of the named Insured. General Liability is Primary and Non - Contributory. 30 days notice of cancellation except for 10 days
<br />for non - payment of premium.
<br />2;z / �G5
<br />v c,�nr,vr„ q n UHNL,MLL)'VI IUIN
<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 />City of Santa Ana jt
<br />20 Civic Center Plaza
<br />Santa Ana CA 92702
<br />© 1988.2094 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD.
<br />
|