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CERTIFICATE OF LIABILITY INSURANCE
<br />MIDD YY)
<br />9!33 /2.01/201 4
<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, 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 />Qealey, _Renton- SAssoclates
<br />P. 0, Box 10550
<br />Santa Ana CA 92711.0550
<br />CNA O TA T
<br />E:
<br />_.__ ._ _
<br />E • -427- - D____
<br />E MAIL
<br />ADDRESS;
<br />INSURER (S) AFFORDING COVERAGE
<br />NAIC p
<br />Y
<br />INSURER A Travelers Proo ftyQaoualty Co of A
<br />a5674
<br />130/2015
<br />INSURED
<br />INSURER B:Travders Casualtv i£ Surety Co. Anne
<br />31194
<br />INSURER C:
<br />_
<br />RJM Design Group, Inc,
<br />31591 Camino Capistrano
<br />San Juan Capistrano CA 92675
<br />INSURER D:
<br />—
<br />INSUREftE_
<br />$1,000,000
<br />INSURER P:
<br />$10,000_,,,,T,,,,_
<br />PERSONAL B ADV INJU RY
<br />COVERAGES CERTIFICATE NUMBER: 160437120 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 DOCUMEN'r 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 />INTR
<br />TYPE OF INSURANCE
<br />1S
<br />D
<br />POLICY NUMBER
<br />POLICY EPF
<br />MIDOl EXP
<br />- LIMITS
<br />GENERAL LIABILITY
<br />Y
<br />Y
<br />3805D390306
<br />(30/2014
<br />130/2015
<br />EACH OCCURRENCE
<br />$2,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE IKI OCCUR
<br />DA WA— RENTED
<br />PR IS S occu enc
<br />$1,000,000
<br />MEDEXP(Anyone emon)
<br />$10,000_,,,,T,,,,_
<br />PERSONAL B ADV INJU RY
<br />X Contractual
<br />Liability
<br />GENERAL AGGREGATE
<br />_$2,000,000
<br />$4,000,000
<br />GEN'L AGGREGATE
<br />T_
<br />LIMIT APPLI ES PER: y
<br />PRODUCTS - COMP /OP AGG
<br />$4,000,000
<br />POLICY
<br />X PRO- LOC
<br />JECT
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />BA513394305
<br />130/2014
<br />/30/20115rr
<br />�gUyA
<br />Ea accident MIT
<br />1,000,000
<br />_...X
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS X AUTN'OSWNED
<br />y9 p,Tq.9'Fi
<br />ray
<br />.,rrydO
<br />/'
<br />J -�.
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTYjDAAGE�$
<br />UMBRELLALIAB
<br />excess LIAR
<br />OCCUR
<br />CLAIMSWAOE
<br />-7
<br />t.ISA
<br />A5518t8 n
<br />City AttD
<br />na(y
<br />b$�
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />DEO RETEEION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYEAWLIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE❑
<br />OFFICER /MEMBER EXCLUDED?
<br />NIA
<br />Y
<br />U84111T9 &0
<br />/30/2014
<br />/3012015
<br />x We S ATU- I JOTH-
<br />TORY I
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />&L, DISEASE - FA EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />If Yyes, dewllbe under
<br />DESCRIPTIONOF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1000000
<br />B
<br />Professional Liability
<br />105991919
<br />;101112014
<br />101112015
<br />Per Claim $1,000,000
<br />Claims Made
<br />Annual Aggr. $2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACDRD 101, Additional Ramndm Schodula, If mare apace Is requInd)
<br />General Liability policy excludes claims arising out of the performance of professional services.
<br />Re: On -Call Services - City Of Santa Ana, CA.
<br />The City of Santa Ana, Its officers, employees and representatives are Additional Insured as respects to General Liability coverage as
<br />required by written contract.
<br />Primary and Non - Contributory applies to General Liability as required by written contract. Waiver of Subrogation for Work Comp is included
<br />as required by written contract,
<br />See Attached..,
<br />CERTIFICATE HOLDER CANCELLATION 30 Dav /10 Dav Notice of Cancellation
<br />©1965 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISION$.
<br />Attn: Marilyn Boothe
<br />P.Q. BOX 1988
<br />UTNORI2ED REPRESENTATIVE v- - -�
<br />✓Y Loll '...
<br />Santa Ana, CA 92702 -1988
<br />©1965 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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