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PSOMAS, INC. (2)
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Last modified
7/2/2018 1:04:44 PM
Creation date
8/15/2017 9:58:46 AM
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Contracts
Company Name
PSOMAS, INC.
Contract #
A-2015-167-01
Agency
Public Works
Council Approval Date
8/4/2015
Expiration Date
8/4/2018
Insurance Exp Date
4/1/2019
Destruction Year
2024
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ACCAR "0 CERTIFICATE OF LIABILITY INSURANCE <br />9/18/2017 Dnvvv) <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 <br />Dealey, Renton & Associates <br />Lic. #0020739 <br />P.O. Box 10550 <br />CONTNAME: Robin Lee <br />PHONE FAX <br />. 714-427-6810 .?14-427 6818 <br />EMAIL , rlee@dealeyrenton.com <br />AbDRESS <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />Santa Ana CA 92711-0550 <br />INSURERA:XL Specialty Insurance Co. <br />37885 <br />INSURED PSOMAS <br />INSURER B: <br />CLAIMS -MADE � OCCUR <br />PSOMAS <br />555 South Flower Street, Suite 4300 <br />Los Angeles CA 90071 <br />_ <br />INSURERC: <br />INSURER D: <br />DAMAGE( RENTED <br />PREMISESSEa occurrence) $ <br />MED EXP (Any one person) $ <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 10712960 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 />ILTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />CLAIMS -MADE � OCCUR <br />DAMAGE( RENTED <br />PREMISESSEa occurrence) $ <br />MED EXP (Any one person) $ <br />PERSONAL & ADV INJURY $ <br />GEML AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $ <br />POLICY PRO ❑ <br />JECT LOC <br />PRODUCTS - COMP/OP AGG $ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ <br />Ea accident <br />ANY AUTO <br />BODILY INJURY (Per person) $ <br />AUTOWNED SCHEDULED <br />BODILY INJURY (Per accident) $ <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE $ <br />Per accident <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />PER OTR - <br />I I <br />AND EMPLOYERS' LIABILITY Y / N <br />STATUTE ER <br />ANY PROPRIETOR/PARTNCUTIVE ❑ <br />OFFICER/MEMBER EXCLUDED?DED? <br />NIA <br />REVIEWED BY: EUNICEHEREDIA PG OF � ENT $ <br />(Mandatory in NH) <br />- LA EMPLOYE $ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $ <br />A <br />Professional Liability <br />DPR9917719 <br />10/15/2017 <br />10/15/2018 <br />Per Claim $1,000,000 <br />Claims Made <br />Annual Aggregate $1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />2SAN410111; Walnut Pump Station Upgrade Project / Agreement NO.= A-2014-224 <br />GtK l ll-IGA l t MULUtF( L;ANGtLLA I IUN OU LJdy INUILI :e UI k dncend UUn <br />City of Santa Ana <br />Attn: Rudy Rosas <br />220 S. Daisy Avenue, M-85 <br />Santa Ana CA 92703 <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 />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />
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