Laserfiche WebLink
�. �. CERTIFICATE LIABILITY INSURANCE <br />DATE(MMIDD/YYYY) <br />7/8/2015 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGRATION IS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does <br />not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER OnPoint Underwriting Inc <br />CON FACT NAME: Steven McComb <br />5390 E Crescent Pkwy, Suite 200 <br />PHONE (A/C, No Ext): (360) 828 -0644 FAX (A/C, NO): (360) 828 -0699 <br />Greenwood Village, GO 80111 <br />SUBR <br />WVD <br />POLICY NUMBER <br />EMAILADDRESS: <br />POLICY EXP <br />(MMIODNYYY) <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURERA: ACE American Insurance Company 22667 <br />INSUREDINSURER <br />B:-_..._,._...-_..,._.. i..,___._...„._.. v._._._._.. ._._,_..__.- ..�,__w._ „_,m.� -„_, <br />Barrett Business Services, Inc. LIC /F <br />INSURER C: <br />CALIFORNIA PROFESSIONAL ENGINEERING INC. <br />INSURER D: <br />929 OTTERSEIN AVE UNIT E <br />INSURER E <br />ROWLAND HEIGHTS, CA 91748 <br />INSURER F. <br />L,L/VCHAUt:S cart l I MCA rt NU MlSrR: 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 INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUES OR MAY PERTAIN. THE INSURANCE AFFORDED BY <br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED <br />BY PAID CLAIMS. <br />MEN <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MMMDA'M) <br />POLICY EXP <br />(MMIODNYYY) <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE El OCCUR <br />DAMAGE DO RENTED PREMISES L. <br />occuronca) <br />MED ESP (Any one person) <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />GENT AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS - COMPIOP AGG <br />$ <br />r— <br />F POLICY I PROJ- LOC <br />ECT <br />$ <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />ALL DWNEO AUTOS SCHEDULED AUTOS <br />�HIREDAUTOS NON- OWNEDAUTOS <br />BODILY INJURY (Par persnn) <br />$ <br />BODILY INJURY (Per accident} <br />$ <br />PROPERTY DAMAGE <br />$ <br />UMBRELLA UAE 'OCCUR <br />EACH OCCURRENCE <br />S <br />EXCESS LIAR OCCUR <br />AGGREGATE <br />$ <br />UEO RETENTION$ <br />-- - - -_�$ <br />A <br />WORKERS COMPENSATION AND EMPIOYERS <br />LIABILITY YIN <br />RWC <br />C48101562 <br />12119114 <br />12/01/2015 <br />,( <br />WC STATU <br />Tonv umnTS <br />OTH <br />ER <br />E.L. EACH ACCIDENT <br />S &000A00 <br />ANY PROPRIE- rORMARTNERI EXECUTIVE y <br />OFFICERIMENIGER EXCLUDED' <br />(Mandatory Iry NfT Iyee, under <br />N / A <br />COVerEld 512te5] <br />CA <br />El, DISEASE - EA EMPLOYEE_ <br />$2,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$g,Og0.000 <br />OF O TIONbe <br />OEBCRIPi'ION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORO 101, Addltlonai Remarks Schedule, If monespace is roqumd) <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana <br />EXPIRATION DATA THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE <br />POLICY PROVISIONS. <br />WITH THE <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701 <br />�`q ",�K"..c° —�, <br />Richard Poling <br />c) 1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/65) The ACORO name and logo are r istore marks of ACORD, <br />VIEWED <br />CALIFORNIA PROFESSIONAL ENGINEERING A- 2015 -090 RE BY: EUNICE HEREDIA (PG 6 OF 7) <br />