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NELSON NYGAARD CONSULTING ASSOCIATES A-2015-042 REVIEWED BY. EUNICE HEREDIA (PG 1 OF 4)
<br />Client#.- 17272 NELSONYGA
<br />ACORD. CERTIFICATE OF LIABILITY INSURANCE
<br />FDATE (MMIDDIYYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />1 10112/2015
<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(les) must be endorsed. IfSUBROGATION 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 />PRODUCERCONTACT
<br />NAME: Julie Nelson
<br />Dealey, Renton & Associates
<br />F - 510 452-2193
<br />PHONE 510 465-3090 jf
<br />(A/C, No).:-.
<br />P. O. Box 12675
<br />E-MAIL
<br />ADDRESS: jnelson@dealeyrenton.com
<br />Oakland, CA 94604-2675
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAfMS-MADE 4 OCCUR
<br />510 465-3090
<br />R(INSURES) AFFORDING COVERAGE MAIC
<br />INSURER A: Travelers Indemnity Co. of Conn 25682
<br />INSURED
<br />B: Travelers Indemnity Company �56
<br />Nelson\Nygaard Consulting
<br />-INSURER
<br />INSURER C , Hartford Ins. Co of Midwest 37478
<br />AI
<br />ssociates6 , nc,
<br />.
<br />.... . . ..... ....
<br />INSURER D, Continental Casualty Company 20443
<br />11New Montgomery Street, Ste. 500
<br />s2,000,000
<br />$4,000,000
<br />San Francisco, CA 94105
<br />INSURER E:
<br />L
<br />GENERAL AGGREGATE
<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 ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />INSIR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />INSRUID
<br />POLICY NUMBER
<br />POLICY EFF POLICY EXP
<br />MMIDD/YYYY I(MMIDDIYYYY) LIMITS
<br />A
<br />GENERAL LIABILITY
<br />68020560298
<br />09101/2015 09101/201E EACH OCCURRENCE
<br />s2,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAfMS-MADE 4 OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES (Ea occurmnlnej
<br />MED EXP (Any one person)
<br />$1,000,000,
<br />$ 1 MOO
<br />PERSONAL & ADV INJURY
<br />s2,000,000
<br />$4,000,000
<br />GENERAL AGGREGATE
<br />s4,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGO
<br />Fy�
<br />POLICY I ^I PRO-
<br />JECT LOC
<br />$
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />BA213560575
<br />09/01/2015
<br />091011201E
<br />C-0—MBNtUsiNdI.LIMIT
<br />E
<br />BODILY INJURY (Per person)
<br />$1,000,000
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />S
<br />X
<br />X NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />(Perscrident)
<br />$
<br />B
<br />UMBRELLA LIAR OCCUR
<br />CUP002G561707
<br />09/0112015
<br />09101/201C
<br />EACH OCCURRENCE
<br />$4,000,000
<br />EXCESS LIAR CLAIMS -MADE
<br />AGGRIE-GA.T.E. .... .......
<br />DIED RETENTION$
<br />$
<br />c
<br />WORKERS L..��fkIECU76VE®
<br />EMPLOYERS' LIABIY YIN
<br />ANPROPRETORIPART
<br />crR/MFmL
<br />57WBGPH9998
<br />09/01120115
<br />091011201CXI
<br />WC STATU- I OTH-
<br />_Jnb_l PORY U101.15-
<br />EAND
<br />E.L. EACH ACCIDENT
<br />S1,000,0 00
<br />E.L. DISEASE - EA EMPLOYEE,
<br />$1,000,000
<br />(Mandatory in NH)
<br />�NIA
<br />If yes. dpscrilop under
<br />DESCRtPTION OF OPERATIONS betow
<br />( ErLPISE�§� POLICY LIMIT � $1,000,000
<br />D
<br />Professional
<br />591867601
<br />12/0112014
<br />12101/20111
<br />$5,000,000 per Claim
<br />Liability 1�
<br />$5,000,000 Ann[ Aggr.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddItIonal Remarks Schedule, if more space is required)
<br />General Liability Policy excludes claims arising out of the performance of professional services.
<br />RE: All operations of the named insured. City of Santa Ana, its officers, employees, agents, volunteers and
<br />representatives are covered as additional insured as respects General and Automobile Liability and such
<br />coverage is primary / non-contributory per policy form.
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />ACORD 25 (2010/05) 1 of 1
<br />#S1492119/M1429305
<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 />@ 1988-2010 ACORD CORPORATION, Ali rights reserved,
<br />The ACORD name and logo are registered: marks of ACORD
<br />9M
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