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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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A� Rte® CERTIFICATE OF LIABILITY INSURANCE <br />9/18/2017TE(MMI D"Y") <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 />CONTACT <br />ONTALee CT Robin <br />Robin <br />PHONE 27-6810 FAX N :714-427-6818 <br />E-MAIL . rlee Beale renton.com <br />@ Y <br />INSURERS AFFORDING COVERAGE NAIC # <br />Santa Ana CA 92711-0550 <br />INSURERA:XL Specialty Insurance Co. ,37885 <br />INSURED PSOMAS <br />INSURER B : <br />PSOMAS <br />555 South Flower Street, Suite 4300 <br />Los Angeles CA 90071 <br />INSURER C : <br />INSURER D : <br />CLAIMS -MADE El OCCUR <br />INSURER E: <br />INSURER F: <br />CAVFRArFR CFRTIFICATF NI IMRFR• 1948540543 DF\/ICInM IIHRARCD- <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 />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />MM% POLID/YYY <br />EXP <br />MMIDDYIYYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />CLAIMS -MADE El OCCUR <br />DAMAGES( RENTED <br />PREMISES Ea occurrence) $ <br />MED EXP (Any one person) $ <br />PERSONAL & ADV INJURY $ <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $ <br />GEN'L <br />POLICY F] PRO JECT ❑ LOC <br />PRODUCTS - COMP/OP AGG $ <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />MBINFD SINGLE LIMI I$ <br />Ea accident <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />(AUTOS AUTOS <br />BODILY INJURY Per accident $ <br />( ) <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 RETENTION $ <br />I $ <br />WORKERS COMPENSATION <br />PER OTH- <br />AND EMPLOYERS' LIABILITY YIN <br />STATUTE ER <br />E.L. EACH ACCIDENT $ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />N / A <br />E.L. DISEASE - EA EMPLOYE $ <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $ <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 $1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />2SAN050900; On -Call Engineering and Landscape Architecture Services; Executed Agreement No. A-2008-219. <br />2SAN050902 Grand Avenue Storm Drain From Channel to 4th Street Design <br />REVIEWED BY: EUNICE HEREDIA (PG 4,O)F/ <br />I,MKI Ir'It.AIG 11ULUr-K GANIa LLAI IUN JU Uay IVUuce UI uarlcellaLlan <br />City of Santa Ana <br />Attn: Clerk of the City Council <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 />©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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