Laserfiche WebLink
A®®CERTIFICATE OF LIABILITY INSURANCE <br />5/9/2016) <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(les) 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 />BOGART & BROWNELL OF MD.INC. <br />7648 Standish Place <br />Rockville bID 20855 <br />CONTACT VST inia SCORE <br />NAME: 9 <br />PHONE (301)444-4500 1 FAx <br />AIC Net: (301)444-4510 <br />pAIESS:9-nny@bogartandbrownell. com <br />INSURERS AFFORDING COVERAGE NAIL # <br />INSURER A:Sentinel Insurance Company LTD 11000 <br />INSURED WINBOURNE CONSULTING, LLC <br />1611 N KENT ST STE 802 <br />ARLINGTON VA 22209 <br />INSURER B:Hartford Casualty Insurance Cc 29424 <br />INSURERCAXiS Insurance Company 37273 <br />INSURER D:Travelers 3609 <br />INSURER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER:2016-2017 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 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 />A D <br />BR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYV <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS <br />John Seguin/RAD <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ 1,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMSMADE®OCCUR <br />423BAPB4058 <br />6/7/2016 <br />6/7/2017 <br />DAMAGE TO RE TED 1,000,000 <br />PREMISES Ea occurrence) $ <br />MED EXP (Any one person) $ 10,000 <br />PERSONAL &ADV INJURY $ 1,000,000 <br />X Deductible - $500 <br />Business Personal Prop: <br />GENERAL AGGREGATE $ 2,000,000 <br />$62,500 - RC - $500 Ded <br />GEHL AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ 2,000,000 <br />POLICY X PIFCT RO1-1 LOU <br />$ <br />AUTOMOBILE <br />LIABILITYCOMBINED <br />OMBI dEDtSINGLE LIMIT $ 1,000,000 <br />BODILY INJURY (Per person) $ <br />A <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />42SBAPE4059 <br />6/7/2016 <br />6/7/2017 <br />BODILY INJURY (Per accident) $ <br />X <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />PRPerOPERTY DAMAGE $ <br />accitlent <br />IS <br />X <br />Ded-$500 <br />X <br />UMBRELLA LAB <br />X <br />OCCUR <br />EACH OCCURRENCE $ 3,000,000 <br />AGGREGATE $ 3,000,000 <br />A <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I X I RETENTION$ 10,00 <br />$ <br />42SBAPB4059 <br />6/7/2016 <br />6/7/2017 <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />lr WC STATU- OTH- <br />E.L. EACH ACCIDENT $ 1 000 000 <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in Ni <br />NIA <br />g2WECCF5270 <br />6/7/2016 <br />6/7/2017 <br />E.L. DISEASE - EA EMPLOYE $ 1 000 000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $ 1,000,000 <br />D <br />Employ Theft of Clent Pro <br />105907770 <br />3/21/2016 <br />3/21/2017 <br />$1,000,000 <br />C <br />Professional Liability <br />42m0270197 <br />6/7/2016 <br />6/7/2017 <br />Retention -$10,000 OCC/AGG $1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, <br />agents, volunteers and representatives are named as additional insureds with regard to liability and <br />defense of suits arising from the operations and uses performed by or on behalf of the named insured. <br />With respect to claims arising out of the operations and uses performed by or on behalf of the named <br />insured, such insurance as is afforded by this policy is primary and is not additional to or contributing <br />with any other insurance carried by or for the benefit of the additional insureds. This insurance applies <br />separately to each insured against whom claim is made or suit is brought except with respect to the <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2010/05) <br />I NSn25 rom nn.ii <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />Thn Arni name and Innn am roniefnrarl ni of Anni <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />The City of Santa Ana <br />X <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />APPROVED AS <br />To FORM <br />AUTHORIZED REPRESENTATIVE <br />�«23 �hc�P✓ <br />John Seguin/RAD <br />ACORD 25 (2010/05) <br />I NSn25 rom nn.ii <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />Thn Arni name and Innn am roniefnrarl ni of Anni <br />