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MIG, INC. 1
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Last modified
11/9/2016 2:26:10 PM
Creation date
11/9/2016 2:23:49 PM
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Contracts
Company Name
MIG, INC.
Contract #
N-2016-156
Agency
PLANNING & BUILDING
Insurance Exp Date
8/31/2017
Destruction Year
0
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Client#: 2042 <br />MOOREIACO <br />ACORD. CERTIFICATE OF LIABILITY INSURANCE <br />DATE 0912016ff <br />911 <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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsoment(s). <br />PRODUCER <br />Dealey,Renton &AssociatesP�ICNdF <br />P. O. Box 12675 <br />Oakland, CA 94604.2675 <br />510 465.3090 <br />CONTACT Jo Lusk <br />NAME: <br />EXt;590465.3090 'A"IX,Nn;510452.2193 <br />EMAI�Ss, jlusk@dealayronton.com <br />_ <br />INSURERISIAFFORDING COVERAGE 'NAICA <br />IN$URERA; Travelers Property Casualty Co 25674 <br />INSURED <br />INSURER 0: Travelers Indemnity Company 25658 <br />Moore lacofano Goltsman, Inc. <br />INSURER C: Twin City Fire Insurance Co. 29459 <br />800 Hearst Avenue <br />Berkeley, CA 94710 <br />INSURER D: ACE American Insurance Company 22667 <br />INSURER E; <br />INSURER F i <br />PRODUCTS -COMPIOP AGO s21000,000 <br />COVERAGE$ 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 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 HAVE BEEN REDUCED BY PAID CLAIMS, <br />LTR <br />TYPE OF INSURANCE <br />ADO <br />9WeeUB <br />POLICY NUMBER <br />MMIDDfYYYFY <br />MMNDYIYYYY <br />LIMITS <br />A <br />B <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE FX OCCUR <br />6801H899998 <br />6801H845960 <br />8/31/2016 <br />8/31/2016 <br />08/31/2017 <br />081311201 <br />_ <br />EACHHOO,CTCTURRENCE $1,000,000 <br />PREMqISES°eo¢Torrence $1000000 <br />MEO E%P An ane erson. $10 000 <br />PERSONAL &ADV INJURY $1,000,000 <br />GEN, AGGREfGAATTE. LIMIT APPLIES PER: <br />POLICY JEC 1:1 LOC <br />OTHER: <br />_ <br />GENERAL AGGREGATE $2,000,000 <br />PRODUCTS -COMPIOP AGO s21000,000 <br />A <br />AUTOMOBILE <br />X <br />X <br />LIABILITY <br />ANYAUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON•OWNE° <br />fIIRED1REp AUTOS X AUTOS <br />BA2G258325 <br />0813112016 <br />08/31/201 <br />_ <br />popclUODtsiNOLE L14h 1,000,000 <br />BODILY INJURY (Por Porson) $ <br />BODILY INJURY (Par accident) $ <br />PROPERTY tlAMgGE <br />(Per eccltlenD $ <br />$ <br />A <br />X <br />UMBRELLALIAR <br />EXCESS LIAR <br />X <br />OCCUR <br />CLAIMS -MADE <br />CUPOH758762 <br />0813112016 <br />08/3112017 <br />EACH OCCURRENCE S110,000 000 <br />AGGREGATE $10 000 000 <br />DED I RETENTI N <br />$ <br />C <br />WORKERS COMPENSATION57WE006 <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARNERIEXECUTIVE YIN <br />OFPICENMEMBEREXCUDED? � <br />I <br />{Mandatory In NH) <br />DESCRIPTION OF OPERATIONS mtow <br />NIA <br />525 <br />04101/2016 <br />04/01/201 <br />X PER DTH. <br />E.L. EACH ACCIDENT $1000,000 <br />E.L. DISEASE -EA EMPLOYEE $1000000 <br />E.L. DISEASE � POLICY LIMIT $1,000,000 <br />D <br />Professional <br />Liability <br />021656434013 <br />07101/201608131/201-o <br />$2,000,000 por Claim <br />$3,000,000 Annl Aggr. <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached It more space Is wquirodi <br />General Liability Policy excludes claims arising out of the performance of professional services. <br />30 Days Notice of Cancellation (10 Days for Non -Payment of Premium). <br />Rep Project #13812,00, Santa Ana, Southern California Association of Governments (SCAG) application for the <br />2016 Sustainability Planning Grants Program. <br />City of Santa Ana Is named as Additional Insured as respects General Liability coverage. See attached A?aveu"rs'. <br />endorsement. <br />City of Santa Ana <br />Attn: Candida Neal <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 />\-. <br />ACORD CORPORATION. All HOME reserved <br />ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD <br />#S1869308/M1815152 AZM <br />0* <br />
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