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Client#: 704
<br />I ZI I I 1001 iT, [0101h"T,
<br />ACORD,,, CERTIFICATE OF LIABILITY INSURANCE
<br />DAT (M iDDIYY
<br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />912912017
<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 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 :CONTACT
<br />NAME: Doris A. Chambers
<br />Dealey, Renton & Associates HONEO, -FAIC, No): 510 452-2193
<br />(PAJC, N E,): 510 465-3090 i
<br />P. 0. Box 12675 E-MAIL
<br />ADDRESS: dchambers@dealeyrenton.com
<br />Oakland, CA 94604-2675 ......... - - ---- - ---
<br />INSURERS) AFFORDING COVERAGENAIC #
<br />510 465-3090 -Sarah D'anjou ii F674___
<br />INSURER A: Travelers Property Casualty Co
<br />INSURED INSURER B : American Automobile Ins. Co.
<br />21849
<br />Ninyo & Moore Geotechnical &
<br />INSURER C: Evanston Insurance Company
<br />35378
<br />Environmental Sciences Consultants
<br />DAMAGE TO RENTED
<br />PR -E -MI -SES (Eci.ocLcqrrence
<br />475 Goddard, Suite 200 INSURER D
<br />XContractual
<br />Irvine, CA 92618 INSURER E:
<br />_
<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
<br />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 HAVL 2�EEN REDUCED BY PAID CLAIMS.
<br />L RR
<br />TYPE OF INSURANCE
<br />�ADDL
<br />INSIR
<br />SUBR'
<br />WD I POLICY NUMBER
<br />POLICY EFF
<br />(MMIDD/YYYY)
<br />I POLICY EXP
<br />!(MM/DD/YYYY) LIMITS
<br />A X COMMERCIAL GENERAL LIABILITY
<br />Y Y 16308986R247
<br />11011112117�
<br />111011201
<br />EACH OCCURRENCE
<br />$1.000,000
<br />CLAIMS -MADE OCCUR
<br />DAMAGE TO RENTED
<br />PR -E -MI -SES (Eci.ocLcqrrence
<br />S1,000,000
<br />XContractual
<br />_
<br />MED EXP (Any one person)
<br />$10,000
<br />X OCP
<br />PERSONAL & ADV INJURY
<br />__..----
<br />$1,000,000
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PR
<br />T LOC
<br />POLICY FY JECo- F,--,--
<br />FPRODUCTS - COMP/OP AGG
<br />s2,000,000
<br />$
<br />OTHER:
<br />------10/-03—/2017110/0-3--/-2---O-1--�
<br />A AUTOMOBILE LIABILITY
<br />Y Y
<br />COMBINED SINGLE LIMIT
<br />(Ea accident) - ----- ___
<br />$1,000,000
<br />X ANY AUTOBODILY
<br />INJURY (Per person)
<br />$
<br />ALL OWNED F SCHEDULED
<br />AUTOSAUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />NON -OWNED
<br />X
<br />Xi HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />_LPeL@cctdant2_.__
<br />$
<br />$
<br />A X: UMBRELLA LIABX
<br />OCCUR
<br />y y
<br />CUP9J428527
<br />10/0312017
<br />10/031201 EACH OCCURRENCE
<br />$9,000,000
<br />$9 000 000
<br />EXCESS LIAS
<br />CLAIMS -MADE
<br />AGGREGATE [�G
<br />DIEDRETENTION $
<br />$
<br />B WORKERS COMPENSATION
<br />Y
<br />WZP81038417
<br />05/01/2017
<br />05/01/2018XZs ATv 10TH
<br />EMPLOYE RS'LIABILITY YIN
<br />,_
<br />- -----
<br />:ANY PROPRIETOR/PARTNER/EXECUTIVE--
<br />E.L. EACH ACCIDENT
<br />$1,000,010
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />:NtA
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />If y s, describe under
<br />e
<br />DE S,R,PT,ON OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />I $1,00o,000
<br />C Professional Liab
<br />Y
<br />MKLV7PL0002608
<br />04/03/2017
<br />10/0312016$5,000,000 per Claim
<br />& Contractor's
<br />$5,000,000 Arml Aggr.
<br />Pollution Liab.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />REF: RFP15-055 Geotechnical, special inspection, & material testing service. GENERAL LIABILITY/AUTOMOBILE
<br />LIABILITY ADDITIONAL INSURED: City of Santa Ana, its officers, employees, agents, Volunteers. Insurance is
<br />Primary and Non-contributory.
<br />[REV�l EUNCE HEREDIA (PG OF
<br />CAN
<br />City of Santa Ana
<br />V7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Public Works Agent ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza D I 1
<br />Santa Ana, CA 9271)'_5qOT,OO i AUTHORIZED REPRESENTATIVE
<br />(9) 1988-20,14 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#82156374/M2154667 DAC
<br />
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