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Client#: 8419
<br />JOHNEKAL11
<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIOD YYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALI. THE TERMS,
<br />1/0812074
<br />THIS CERTIFICATE IS ISSUED ASA 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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 />Np E; C Marie Swaney
<br />Dealey, Renton & Associates
<br />'�l'p3 ®�
<br />PONE —
<br />Arc, No Eat : 626.844.3070 (AIC. Ne
<br />199 S Los Robles #540 C`�®� I
<br />E-MAIL mswane Insdra.com
<br />ADDREas: swanoy@lnsdra.com
<br />Pasadena, CA 91101
<br />12113/2014
<br />Lic#0020739
<br />AFFORDING COVERAGE NAIC p
<br />INSURERA:Travelers Property Casualty Co 25674
<br />X COMMERCIAL GENERAL LIABILITY
<br />��
<br />CLAIMS -MADE L..^J OCCUR
<br />INSURED
<br />INSURER B_: Hudson Insurance Company 25054
<br />John Kaliski Architects Gibe Urban Studio
<br />3780 Wilshire Blvd., Suite 300
<br />INSURER C:
<br />$2000000
<br />Los Angeles, CA 90010
<br />INSUER O:
<br />213.383.7980
<br />NSURRER E;
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALI. THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />TSR
<br />TYPB OFIN$URANGE
<br />N8R
<br />S p
<br />POLICY NUMBER
<br />MMNO/YE P
<br />(MMI)U11EYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />x
<br />x
<br />68087081-374
<br />12113/2013
<br />12113/2014
<br />EACH
<br />12,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />��
<br />CLAIMS -MADE L..^J OCCUR
<br />p pOCCTURRENCE
<br />PREM$ S E.ENTED
<br />e acourrenoa
<br />$2000000
<br />MED EXP (Anyone person) $10,000
<br />PERSONAL&ADV INJURY $2,000,000
<br />X Contractual Liab
<br />GENERALAGGREGATE $4,000,000
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS .comp/op AGO $4,000,000
<br />POLICY
<br />N JECOT 7 LOC
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />BA8708L755
<br />12/13/2013121131201
<br />COMaBMMEeDSINOLE LIMIT nni 1,000000
<br />BODILY INJURY (Per person) $
<br />ANY AUTO
<br />X
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />BODILY JURY (Per accidnt )
<br />BOINJURY $
<br />PROPERTY DAMAGE $
<br />Per seamed)
<br />$
<br />X
<br />No Owned Auto
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE $
<br />AGGREGATE $
<br />B%CRSS LIAR
<br />CLAIMS -MADE
<br />QED I I RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANNY PROPRIETOR/P ARTNERIEXECUTIVE Y IN
<br />OFFIC E B REX LUDED7 ®
<br />N!A
<br />UB5276Y706
<br />01/09/2014
<br />01/09/201
<br />X we sTATu- —To
<br />E.L. EACH ACCIDENT $1000000
<br />E.L. DISEASE - EA EMPLOYEE $1000000
<br />(Mandatory In NH)
<br />�ESSCRIPTIUN OF OP RATIONS below
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />IS
<br />Professional Liab
<br />AEE7242904
<br />12111/2013
<br />12/111201
<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-ownod auto Is the maximum coverage that applies
<br />Re: Pre -Design AS for Bristol St Prop, Washington Ave & 17th St, Santa Ana, CA -- City of Santa Ana, Its
<br />officers, employees, agents,volunteers and representatives are named as additional insured as respects
<br />(See Attached Descriptions)
<br />City of Santa Ana*
<br />20 Civic Center Plaza
<br />PO BOX 1988 M-21, '
<br />Santa Ana, CA 92702
<br />ACORD 25 (2010/05) 1 of 2
<br />#584789S/M840784
<br />'E"1) AS T(.)
<br />Assistant It S'kcedy"'
<br />Cn,Y Atiorrj `y
<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 />REPRESENTATIVE
<br />(01988.2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ADORED
<br />MGS
<br />
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