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A - 2 o ►` t. 2-" • o f
<br />PAULUS ENG
<br />ACORO`
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDIYYYY)
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(sl.
<br />PRODUCER
<br />THE BROKERAGE COMMERCIAL INSURANCE SERVICES, Inc.
<br />20261 SW Acacia St., Suite 200
<br />Newport Beach, CA 92660
<br />INSURED
<br />Paulus Engineering, Inc.
<br />2871 E. Coronado Street
<br />Anaheim, CA 92806
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />INC, No, Ext): (949) 287-5677 (AIC, No):
<br />E-MAIL
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />INSURER A: Executive Risk Indemnity, Inc.
<br />INSURER B: Federal Insurance Company
<br />INSURER C :
<br />INSURER D
<br />INSURER E
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />NAIC #
<br />35181
<br />20281
<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
<br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR TYPE OF INSURANCE AD SUER
<br />LTR SD WVO POLICY NUMBERIMMIDDIYYYYI
<br />PMLpD EFF POLICY EXP LIMITS
<br />A X COMMERCIAL GENERALLIABILITY
<br />EACH OCCURRENCE $
<br />1,000,000
<br />CLAIMS -MADE X OCCUR 54303105
<br />5/1/2019 5/1/2020 DAMAGE TO RENTED
<br />100,000
<br />X
<br />PREMISES (En occurrence) $
<br />5,000
<br />MED EXP (Any one person) $
<br />PERSONAL &ADV INJURY $
<br />1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE S
<br />2,000,000
<br />POLICY X PEA LOG
<br />PRODUCTS - COMP/OP AGG $
<br />2,000,000
<br />OTHER'
<br />$
<br />B AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />1,000,000
<br />$
<br />X ANY AUTO 54303104
<br />5/1/2019 5/1/2020 BODILY
<br />BODILY INJURY (Per person) $
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident) $
<br />HIRED NON -AWNED
<br />PROPERTY DAMAGE
<br />AUTOS ONLY AUTOS ONLY
<br />(Peraccidem) S
<br />S
<br />UMBRELLA LIAB OCCUR
<br />EACH OCCURRENCE S
<br />EXCESS LIAB CLAIMS -MADE
<br />AGGREGATE $
<br />DED RETENTION$
<br />$
<br />B WORKERS
<br />ND EMPLOYERS' LIABILIITY
<br />X PER H
<br />YIN
<br />STATUTE ER _
<br />PROPRIETOWPARTNEWEXECUTIVE 54303106
<br />SI712019 $/1 /2020
<br />E.L. EACH ACCIDENT $
<br />1,000,000
<br />AApNY
<br />FFFICERIMtor,rE BERNH) EXCLUDED? NIA
<br />1,000,000
<br />If yes, describe under
<br />E.L. DISEASE - EA EMPLOYEE $
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $
<br />DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be
<br />attached if more space is required)
<br />RE: Santa Ana Emergency Work. RE: Santa Ana Emergency Work. glaip
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Named as Additional Insureds as respects General Liability
<br />per
<br />Attached Endorsement.
<br />This Insurance shall apply as Primary and Non -Contributory per attached endorsement.
<br />REVIEWED BY:
<br />/V/l%
<br />City of Santa Ana
<br />220 S. Daisy Ave., M-85
<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 />ACORD 25 (2016103) 9)1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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