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Last modified
2/14/2018 3:33:42 PM
Creation date
2/14/2018 3:28:53 PM
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Contracts
Company Name
ACCO ENGINEERED SYSTEMS
Contract #
A-2017-158-01
Agency
PUBLIC WORKS
Council Approval Date
6/20/2017
Expiration Date
3/31/2018
Insurance Exp Date
10/1/2018
Destruction Year
2023
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"� ®® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DD <br />as/zvzon <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 pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Aon Risk Insurance services West, Inc. <br />LOS Angeles CA Office <br />707 wit shire Boulevard <br />Suite 2600 <br />CONTACT <br />NAME: <br />(_C No. E.I): (866) 283-7122 jaC. NP.: (800) 363-0105 <br />EMAIL <br />ADDRESS: <br />Los Angeles CA 90017-0460 USA <br />YIPKGU949ZOOEACH <br />INSURER($) AFFORDING COVERAGE NAICN <br />INSURED <br />INSURERA: Indian Harbor Insurance Company 36940 <br />ACCO Engineered systems, Inc. <br />6265 sae Fernando Road <br />Glendale CA 91201 USA <br />INSURERS: Arch Insurance company 111$0 <br />INSURER C: Arch indemnity Insurance Company 30830 <br />INSURER D: Berkley Assurance Company 39462 <br />INSURER E: <br />INSURER F: " <br />COVERAGES CERTIFICATE NUMBER: 570068459558 <br />RFVIRION NIIMRFR, <br />THIS IS TO CERTIFY THATTHE 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. Limits shown are as requested <br />INS <br />LTR <br />TYPE OF INSURANCE <br />mot <br />SD <br />MD <br />POLICY NUMBER <br />POUCYEFF <br />mwo <br />MWOOPYYYY1 <br />LIMITS <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />YIPKGU949ZOOEACH <br />eJQyon ✓LAR✓fw9ufaaaae e.7siaVx.A <br />/.Vt4rw �aaa <br />OCCURRENCE $1,000,000 <br />CLAIMS -MADE OCCURMAG <br />oNHVr $300,600 <br />PREMISES Me ce <br />MED EXP (Any ono per eon) $5,000 <br />PERSONAL S ADV INJURY $1,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE $2,000,00 <br />rn POLICY L.X PRO X Loc <br />PRODUCTS -COMPIOPAGG $2,000,000 <br />OTHER: <br />B <br />AUTOMOBILE LIABILITY <br />71PKG8949200 <br />B-761-72-517 <br />To -76172618 <br />COMBINED SINGLE LIMIT <br />n a"Idern $2,000,000 <br />BODILY INJURY (Per person) <br />X ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLYAUTOS <br />HIREDAUTOS NON -OWNED <br />ONLY H AUTOS ONLY <br />BODILY INJURY (Per emidenp <br />PROPERTYDAMAGE <br />Per accident <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />YIN y/N <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICEWMEMBER EXCLUDED9 <br />(Mandatory In NH) <br />If yes,descnbe end r <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />71WC18949100 <br />AOS <br />74wC18949000 <br />CA <br />10 01/201 <br />10/01/2017 <br />775-172-618 <br />16/01/261$ <br />PE � OST <br />X stATUTE <br />E.L. EACH ACCIDENT $1,000,000 <br />E.L. DISEASE -EA EMPLOYEE $1,000,000 <br />E.L. DISEASE -POLICY LIMIT $1,000,000 <br />D <br />Env Contr Prof <br />PCADB50027761 17 <br />Claims Made <br />SIR applies per policy ter <br />10/Ol/ 017 <br />s &condi <br />10/01 2018 <br />ions <br />Aggregate Eac Loss $2,000,000 <br />prof Agg SIR $600,000 <br />prof Each claim SIR $200,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be etW.h.d B more space N required) <br />[RE: construction, ACCO Job No. 717624, Job NO. 17-056, HVAC Replacement at the SARTC, 1000 E. Santa Ana Blvd., Santa Ana, CA <br />9270 <br />[AI: city of Santa Ana and all other entities as required by contract] are included as Additional Insured with respect to the <br />General Liability POlicyi and General Liability Policy evidenced herein is Primary to other insurance available as required by <br />written contract but limited to the operations of the insured under the said contract. <br />REVIEWED BY:� EUNIGE HEREDII OF. ) <br />CERTIFICATE HOLDER CANCELLATION 0 <br />©19882015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE <br />CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />City Of Santa Ana <br />AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza <br />Santa Ana CA 92701 USA <br />eJQyon ✓LAR✓fw9ufaaaae e.7siaVx.A <br />/.Vt4rw �aaa <br />©19882015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />
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