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Client#: 8419
<br />JOHNEKALI1
<br />ACORD., CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDNYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />3/10/2014
<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 pollcy(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 />kAMTEACT Marie Swaney
<br />Dealey, Renton & Associates
<br />PHONE 926.844 -3070 FAX
<br />AIC No Ell: AIC, No):
<br />199 S Los Robles #540
<br />E-MAIL S: mswaney @insdra.com
<br />Pasadena,
<br />12/13/2014
<br />EACH OCCURRENCE
<br />Llc#0020739
<br />ic #00
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A; Travelers Property Casualty Cc
<br />25674
<br />INSURED
<br />INSURER B: Hudson Insurance Company
<br />25054
<br />John E Kaliski dba John Kaliski Arch...
<br />INSURER C:
<br />$10,000
<br />3780 Wilshire Blvd., Suite 300
<br />$2,000000
<br />Los Angeles, CA 90010
<br />INSURER D:
<br />213. 383 -7980
<br />INSURERS:
<br />INSURER F
<br />$4,000,000
<br />iiallX-7_[HX-9
<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 CONTRACTOR 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 />INSR
<br />LTR
<br />rypE OF
<br />AODL
<br />INSR
<br />SUBR
<br />MD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MM /DD/YYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X
<br />X
<br />68067081_374
<br />12113/2013
<br />12/13/2014
<br />EACH OCCURRENCE
<br />$2 000,900
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE LJ OCCUR
<br />PREMISES EeoNN.Twrence
<br />$2000,000
<br />MED EXP (Any one person)
<br />$10,000
<br />PERSONAL &ADV INJURY
<br />$2,000000
<br />x Contractual Liab
<br />GENERAL AGGREGATE
<br />$4,000,000
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS - COMNOP AGO
<br />$4,000,000
<br />POLICY
<br />X PRO LOC
<br />JET
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />x
<br />BA67081_755
<br />12/13/2013
<br />12/13/201
<br />Ee aBINEDt SINGLE LIMIT
<br />$1,000,000
<br />BODILY INJURY(Per person)
<br />$
<br />ALLOWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY Per accident
<br />C )
<br />X
<br />HIREDAUTOS X ON -0WNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />$
<br />X
<br />o Owned Auto
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />OCCUR
<br />CLAIMS -MADE
<br />kOVEDASTOFORM
<br />EACH OCCURRENCE
<br />$
<br />HO E
<br />y Attorn
<br />AGGREGATE
<br />$
<br />DED RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'UABILITY YIN
<br />ANY PROPRIETOR /PARTNER/EXECUTIVE
<br />OFFICER /MEMBER EXCLUDED?
<br />NIA
<br />x
<br />UB5276Y706
<br />1/09/2014
<br />011/09)'20115
<br />X WCSTATU- OTH-
<br />ER
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000 000
<br />(Mandator, in NH)
<br />DE SCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />B
<br />Professional Liab
<br />AEE7242904
<br />12/11/2013
<br />12/11/2014
<br />$1,000,000 per claim
<br />Claims Made Form
<br />$2,000,000 annl aggr.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, AddItIonal Remarks Schedule, If more space is required)
<br />Cancellation Notice: 30 Day /10 Day for non -pay of premium will be mailed to the certificate holder. General
<br />Liability policy excludes claims arising out of the performance of professional services. Insured owns no
<br />company vehicles; therefore hired /non -owned auto is the maximum coverage that applies.
<br />Re: On -call services for Urban Design & Architectural Consulting -- The City of Santa Ana, its officers,
<br />employees, agents, volunteers and representatives are named as additional insureds as respects general &
<br />(See Attached Descriptions)
<br />City of Santa Ana*
<br />Attn: Exec. Dir of PBA
<br />20 Civic Center Plaza
<br />PO BOX 1988
<br />Santa Ana, CA 92702
<br />ACORD 25 (2010105) 1 of 2
<br />#S911178/M840751
<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 />(0 19BB -2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />MGS
<br />
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