TRANSPORTATION STUDIES INC. (2) - 2017

Home Browse Search

A� br CERTIFICATE OF LIABILITY INSURANCE DA9/28/200 8 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Erica Hornada NAME: y PHONE FAX A/C No Ext1: A/C No): The Empire Company 550 North Park Center Drive E-MAIL ADDRESS: y p ehornada @em ire-co.com Suite 205 INSURERS AFFORDING COVERAGE NAIL # INSURERA:Ohio Security Insurance Company 24082 Santa Ana CA 92705 INSURED INSURER B: American Fire and Casualty Insurance Cc 24066 INSURERC:United States Liability Insurance Com a 25895 Transportation Studies Inc INSURER D: 2640 Walnut Ave Ste L INSURER E: INSURER F: Tustin CA 92780 COVERAGES CERTIFICATE NUMBER: 2018/2019 MASTER REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY MM DD/YYYY POLICY EXP MM DDfYYYY LIMITS X COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE FOOCCUR DAMAGE TO RENTE PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 15,000 BKS59050934 10/1/2018 10/1/2019 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 0 PRO F_� LOCPRODUCTS-COMP/OPAGG JECT $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BAS59050934 10/1/2018 10/1/2019 BODILY INJURY (Per accident) $ NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE $ Per accident BACEE $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 B EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 10,000 $ USA59050934 10/1/2018 10/1/2019 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N X I PER OTH- STATUTE ER .. E.L. EACH ACCIDENT $ 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A XWS59050934 10/1/2018 10/1/2019 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 C ERRORS 6 OMISSIONS SP1022743G 10/1/2018 10/1/2019 LIMIT 1,000,000 DEDUCTIBLE 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: Agreement to Provide Traffic Counting Services on an On -Call Basis The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insureds with primary/non-contributory wording in respect to the general liabilty coverage per forms CG88100413 attached as required by written contract. REVIEWED BY: EUNICE HEREDIA (PG OF ) VII CERTIFICATE HOLDER CANCELLATION ZKekula@santa-ana.org City of Santa Ana 20 Civic Center Plaza, M-43 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ica Hornaday/ERICA v1IWa All rinhtc racar rarl ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)