Laserfiche WebLink
MA�HOMAS AND COMPANY A, 201'5-173 REVIEWED BY: <br />EUNICE HEREDIA (PG 8 OF 8) <br />AC(?RG► CERTIFICATE OF LIABILITY INSURANCE <br />il,. <br />........... <br />DATE(MMIDD/YYYY) <br />11 d5/2015 <br />THIS CERTIFICATE, IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TH15 <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY T'H'E, POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S)y AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) roust 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 endorsements . <br />PRODUCER <br />Dealey, Renton & Associates <br />P. ©. Box 12675 <br />Oakland, CA 94604-2675 <br />.CONTACT <br />NAME David C. Eckman <br />PHONE 510 465 30J0 FAX <br />E-1WAIL <br />IN'.SURER S. AFFORDING COVERAGE. <br />NAIC IN <br />INSU'RERA:XL Specialty Insurance Co, <br />37885 <br />INSURED MARKTHOMA. <br />Mark Thomas & Company, Inc. <br />1960 Zanker Road <br />INSURER B :.... <br />INSURER.C: <br />San Jose, CA 95112 <br />INSURER D : <br />INSURER E <br />408 453-5373 <br />INSURER F : <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 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 />INSR. <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MMIDDIYYYY <br />P ILCY EXP <br />MMfDDIYYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MAQE. OCCUR <br />EACH OCCURRENCE <br />S <br />15A-PAGE TO RENTED <br />PREMISES Ea accuarrence <br />$ <br />MED EXP (Any one person.) <br />PERSONAL & ADV INJURY <br />$. <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO - <br />POLICY ] JECT � LOC <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS - COMP/OP AGG <br />$ <br />$ <br />OTHER:. <br />AUTOMOBILE <br />LIABILITY <br />COMBccidervlO NEQ SINGLE LIMIT <br />Ea a <br />$ <br />ANY AUTO <br />BODILY INJURY (Per person) <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accvdent) <br />S <br />NON! -OWNED <br />HIRED AUTOS AUTOS <br />'... PROPERTY DAMAGE <br />Per accadenl. <br />$ <br />UMBRELLA LIAB <br />OCCUR... <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />DEL) RETENTION$" <br />WORKERS COMPENSATION <br />PER OTH'.AND <br />EMPLOYERS' LIABILITY Y f N <br />STATUTE ER. <br />RS <br />E.L. EACH ACCIDENT <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICER'lMEMBER EXCLUDED? <br />N t A <br />''' <br />E.L. DISEASE - EA EMPLOYIf <br />(Mandatory in NH) <br />yes, descrdbe under <br />DESCRIPTION UHF OPERATIONS below <br />E.L. DISEASE - POLICY LIMI <br />A <br />Professional Liability <br />DPR9725035 <br />7/112015 <br />7J112016 <br />$2,000,000 PerClairn <br />$2,000,000 Ann] Aggregate <br />DESCRIPTION Or OPERATIONS I LOCATIONS l VEHICLES (ACORD 10 1, Additional Remarks Schedule, may be attached if more space is required) <br />REF: MTC"s Job #IR-15103 On -Call. Engineering Services. Cancellation provisions are solely as shown on this certificate. Cancellation: 30 <br />Day(10 Day for Non -Payment of Prernlurn, <br />—+... —I- e..v�v ten,. 4/-V IN4 CLLH I MIN IV -CY INLJ f I LJOY IUI INUIlydy UI r`IUIII <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <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 />Uc 1988-2.014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />