POWER ENGINEERS, INC. 1B - 2013 - Laserfiche WebLink

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,ac"Rcar CERTIFICATE F LIABILITY I �+---'"` INSURANCE CE D (DD 3/24/2015 24/ / 2 01155 / / 2 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jerry NO Ola NAME: y y Greyling Insurance Brokerage 3780 Mansell Road PHONE (770) 552-4225 FAC No: (866) 550-4082 E-MAIL err no ola@ re lin ADDRESS:' y• y g Y g. com INSURERS AFFORDING COVERAGE NAIL # Suite 370 INSURERA-National Union Fire Ins Co 19445 Alpharetta GA 30022 INSURED INSURER B :New Ham shire Insurance CoMany 23841 POWER Engineers, Inc. INSURER C:S ndicate 2623/623 at Llo drs 3940 Glenbrook Drive INSURER D: INSURER E: P.O. BOX 1066 INSURER F Hailey ID 83333 COVERAGES CERTIFICATE NUMBER:15-16 (PEI) REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TypE OF INSURANCE ADDL SUBR POLICY NUMBER&ULfYYYY POLICY EFF POLICY EXP MM/DD(YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY _ DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 A CLAIMS -MADE ® OCCUR 5094741 4/1/2015 4/1/2016 _ MED EXP (Any one person) $ 25,000 PERSONAL& ADV INJURY $ 1,000,000 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GENT. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 17 POLICY X PRO-JFQI X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTO 6403759 (AOS) 4/1/2015 4/1/2016 BODILY INJURY (Per accident) $ A X HIRED AUTOS X OWNED 6403760 (MA) 4/1/2015 4/1/2016 PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION I $ B WORKERS COMPENSATION 039901492 (AOS) 4/1/2015 4/1/2016 X WCSTATU- OTH- I ER AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 1,0001000 ANY PROPRIETOR/PARTNER/EXECUTIVE � N/A A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 039901493 (CA) 4/1/2015 4/1/2016 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS below CD Professional Liability 13;397150301 —FE 4/1/2015 4/1/2016 Per Claim $5,000,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS ( LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officers, employees, agents, volunteers & representatives are named as Additional Insureds on the above referenced liability policies with the exception of workers compensation & professional liability where required by written contract. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' written notice (except 10 days for nonpayment of premium) will be provided 0 th Certificate Holder named below. POVVrd—R ENGINEERS, INC A-2013-006-0 REVIEWED BY: � ° � . a 6.:,1. NICHE: I--WIEREDIA (('G 1 OF 6) Mani lri iAir_nULLJCr% IA1Vl.CLLA I IV IV City of Santa Aria Purchasing Department 20 Civic Center Plaza Santa Ana, CA 92701 AU(JKU Zb (ZUIU/Ub) INS025 (gotnoa) of SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE avid Collings/JERRY :971�tt:3'f'I�i[�1�iK•]N•rT�l 7:ir1a7±��Ci is � Tlea ar:npr1 name and Innn aro ranictarael markc of Arr)pn