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Client#: 17272
<br />NELSONYGA
<br />ACORD,. CERTIFICATE OF'LIAB,ILITY INSURANCE
<br />[�TEDIYYYY)
<br />�'Mm'
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />2512015
<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 />-holder "i"s"
<br />IMPORTANT: If the certificate 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 />CONTACT
<br />Julie Nelson
<br />Dealey, Renton & Associates
<br />PHONE 11 ----1 F
<br />Ex11: 510 465-3090 10452-2193
<br />P. O. Box 12675
<br />_tA�,I,
<br />E-MAIL ...........
<br />deals
<br />jnelson@yrenton.com
<br />Oakland, CA 94604,-2675
<br />-ADDRESS:
<br />510 465 3090
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURER A: Travelers Indemnity Co. of Conn
<br />25682
<br />-- ----
<br />INSURED
<br />INSURER B: Travelers Property Casualty Co
<br />25674
<br />NelsonNygaard Consulting
<br />INSURER C: Hartford Ins, Co of Midwest
<br />37478Associates,
<br />Inc.
<br />INSURER D, Continental Casualty Company
<br />20443
<br />116 New Montgomery Street, Ste. 500
<br />$10,000
<br />San Francisco, CA 94105
<br />LINSURE� E:
<br />---- ------
<br />1 INSURER F;
<br />PERSONAL & ADV INJURY
<br />UUVt:KAUL5 CERTIFICATE NUMBER! PF:VIqintd Idl i"PIPP.
<br />THIS IS TO CERTIFY THAT THE POL01ES 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 POL0ES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />INSR ADDLISUBR POLICY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE INSR ]YffBi- POLICY N ' UMBER I Imm, F LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />68026560298
<br />0910112015
<br />09/0'1/2016
<br />EACH OCCURRENCE
<br />$2.000,000
<br />CLAIMS -MADE I Al OCCUR
<br />DAMAPREM $1EEJ?ERENrTEr1re�ce
<br />000,000
<br />— — -- _-_ --- _- - . .. . .........
<br />MED EXP (Any one persan�
<br />$10,000
<br />PERSONAL & ADV INJURY
<br />$2,009,000
<br />GENERAL AGGREGATE
<br />$4,000,000
<br />GFN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />PR-
<br />FOLEY [X] JECOT LOC
<br />PRODUCTS-COMP/OP AGO
<br />$4,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />BA2G560575
<br />09/0112015
<br />09/011201(
<br />i��ED SINGLE UMIT
<br />CEO, M,,I'��E D S 1 N G LE L'MT
<br />ident)
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY Per accident)
<br />$
<br />X NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGEX
<br />$
<br />B
<br />X
<br />UMBRELLA LIAB X OCCUR
<br />CUP2G561707
<br />09/0112015
<br />0910112016
<br />EACHOCCURRENCE
<br />$4,000000
<br />EXCESS LIAB CLAIMS -MADE
<br />AGGREGATE
<br />$4,000000
<br />__—FRETENTION$
<br />DED
<br />$
<br />c
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />57WBGPH99'98
<br />09101/2015
<br />09/01/2016,&
<br />PER FFO—TH -
<br />2IAIUIEL_LER.___
<br />_-
<br />YIN
<br />ANY PROPRIETOR)PARTNEREXECUTIIVE[N]
<br />OFFICERIMEMBER EXCLUDED?
<br />I A
<br />E.L. EACH ACCIDENT
<br />$11,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />I (Mandatory in NH)
<br />If yes describe under
<br />E.L. DISEASE -POLICY LIMIT
<br />0,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />D
<br />Professional
<br />MCH591867601
<br />1210112015
<br />09/011201
<br />$5,000,000 per Claim
<br />Liability
<br />$5,000,000 Aggregate
<br />DESCRIPTION OF OPERATIONS X LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached 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 I non-contributory per policy form.
<br />REVIEWED BY. INICE HEREDiA (PG J _F t.
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />ACORD 25 (2014101) 1 of 1
<br />#S1536669/M1535406
<br />111HIE,
<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 />@ 1988-2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />NMF
<br />
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