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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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AC40RDI CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMroD/YYYY) <br />1/412018 <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 />PRODUCERCONTACT <br />•-- <br />Dealey, Rentor/ & Associates — <br />License #0020739 <br />P..0. Box 10550 <br />Santa Ana CA 92711-0550 <br />NAME: - <br />PHONEAX <br />. 714-427-6810('Ale,No : 714-427-6818 <br />_ <br />ADDARESS: riee@dealayronton.com <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A: XL Specialty Insurance Co. 37885 <br />INSURED PSOMA9 <br />PSOMAS <br />INSURER B <br />555 South Flower Street, Suite 4300 <br />INSURERC: <br />INSURER D: <br />Los Angeles CA 90071 <br />INSURER E: <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 1619397522 REVISION.NUMBER: <br />THIS IS TO C.F_RTIFY 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 />ILSRR <br />OF INSURANCE <br />ADDLITYPE <br />iNgn <br />wvn SUER <br />POLICY NUMBER <br />MMIDD/YYYF <br />POLICY EXP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />CLAIMS -MADE F]OCCUR <br />DA A TO RENTEU--- <br />PREMISES Ea occurrence $ <br />MED EXP (Any one person) $ <br />PERSONAL & ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO <br />GENERAL AGGREGATE $ <br />POLICY ❑ JECT El LOG <br />PRODUCTS - COMPIOP AGG $ <br />$: <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />- <br />COMBINED SINGLE LIMIT $ <br />Ea accident <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) $ <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE $ <br />Pe accident <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED RETENTION $ <br />_ <br />$ <br />WORKERS COMPENSATION <br />PER OTH- <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNER/EXECUTIVEENT <br />OFFICER/MEMBER EXCLUDED? ❑ <br />(Mandatory In NH) <br />N/A <br />STATUTE I I ER <br />-$ _ <br />REVIEWED BY: EUNICE HEREDIA(PeSOF' EMPLOYE $ <br />4 <br />Ues describe under <br />SGtRIPTION OF OPERATIONS below <br />_ E.L. DISEASE - POLICY LIMIT 1-s <br />A <br />Professional Liability <br />Claims Made <br />DPR9917719 <br />10/15/2017 <br />10/15/2018 <br />Per Claim $1,000,000 <br />Annual Aggregate $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attachad If more space Is required) <br />2SAN051200, Engineering Design Services For Rehabilitation Of City Well 29, SEE CANCELLATION SECTION of Certificate for 30 Day Notice of Cancellation. <br />VCI[ I IrIVA 1 G rIVLUCR 6ANUIZI_I_A I IUfv JU uaV Nonce or uancenavon <br />City Of Santa Ana <br />20 Civi Center Plaza (M-21) <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 />AUYHORIZED REPRESENTATIVE <br />h l.rsa. J k Cv, fD <br />(019BB-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />
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