Laserfiche WebLink
fiiiii CERTIFICATE OF LIABILITY INSURANCE <br />L...."� <br />DATE IDD013 <br />10/17/2013 <br />THIS CERTIFICATE 15 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, subject to <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 <br />The Empire Company <br />550 Parkcenter Drive <br />Suite 205 <br />Santa Ana CA 92705 -3521 <br />CONTACT Erica Hornaday <br />4)836 -9945 c No: 14836 -9946 <br />. corn <br />O $hornday @empire -co. <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURER A:Hanover Insurance Co. <br />LIMITS <br />INSURED <br />Transportation Studies, Inc. <br />2640 Walnut Avenue <br />Unit H <br />Tustin CA 92780 <br />INSURER R Massachusetts Bay Insurance <br />INSURERc:United States Liability <br />25895 <br />INSURER D: <br />INSURER E: <br />$ 1,000,000 <br />INSURER F: <br />X COMMERCIAL GENERAL LIABILITY <br />X CLAIMS-MADE ❑OCCUR <br />COVERAGES CERTIFICATE NUMBER :2013 /2014 Master 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 />IRSIR <br />TYPE OF INSURANCE <br />ADOL <br />NSR <br />SUER <br />MD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDONYYVY <br />POLICY EXP <br />(MMIODri <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />X CLAIMS-MADE ❑OCCUR <br />DEE370.1724800 <br />10/1/2013 <br />10/1/2014 <br />PREMGE TOR <br />$_ 300,000 <br />MED EXP(My one person ) <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />_ <br />$ 2,000,000 <br />GEN. AGGREGATE <br />LIMIT APPLIES PER: <br />PRODUCTS � COMROP AGO <br />$ 2,000,000 <br />$ <br />X POLICY <br />PRO DOE <br />AUTOMOBILE LIABILITY <br />COMB`INE�DLSINGLE LIMIT <br />1 000 000 <br />BODILY INJURY (Per person) <br />_ <br />$ <br />A <br />X ANY AUTO <br />ALLOWNED SCHEDULED <br />AUr11 AUTOS <br />W3A11710500 <br />10/1/2013 <br />10/1/2014 <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />Medical payments <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />AGGREGATE <br />$ 1,000,000 <br />A <br />EXCESS LAB <br />CLAIMS -MADE <br />LA11724800 <br />_X:j <br />DED RETENTION <br />$ <br />10/1/2013 <br />10/1/2014 <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORJPARTNERIEXECUTIVE❑ <br />X WC STATU- I OTH <br />TORY 1 LUNE ER <br />E, L. EACH ACCIDENT <br />$ 1,000,000 <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />NIA <br />3A11724400 <br />0/1/2013 <br />10/1/2014 <br />E. L. DISEASE - EA EMPLOYE <br />$ 1 000 000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE POLICY LIMIT <br />i$ 1 000 000 <br />C <br />Errors & Omissions <br />SPI022743B <br />0/1/2013 <br />10/1/207.4 <br />LIMIT 1,000,000 <br />DEDUCTIBLE 1,000 <br />O ESCRETION OF OPERATIONS I LOCATIONS I VEHICLES (Attach AC ORD 101, Additional Remarks Schedule, if more space Is required) <br />RE: On -Call traffic counting service. Certificate Holder is named as additional insureds with primary <br />and non - contributory wording with respect to general liabilty per forms 391 -10066 06 09 & 391 -1,331 06 09 <br />attached as required by written contract, <br />A'S "z���iSM <br />Assistant Ulty ALL br. •'.: <br />SHOULB 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 />City of Santa Ana <br />Attn: Shahir Gobran <br />20 Civic Center Plaza, M -43 AUTHORIZED REPRESENTATIVE <br />Santa Ana. CA 92702 <br />Hornaday /ERICA C/YX%O "t- Jtl2e�L'�t� —" <br />IN$02Fooinmfi nl The ArnRn name and Inns am ronicle rod,00r4e of Arnan <br />All rights reserved. <br />