|
WOOLINC-01
<br />16. —� J 4/29/201I CERTIFICATE OF LIABILITY INSURANCE DATE (M201YYY)
<br />`9
<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(s).
<br />PRODUCER
<br />Ames 8: Gough
<br />8300 Greensboro Drive
<br />Suite 980
<br />McLean, VA 22102
<br />INSURED
<br />Woolpert Inc.
<br />4454 Idea Center Boulevard
<br />Dayton, OH 45430-1500
<br />PHONE FAX
<br />- (A/C, No,
<br />Ext): (703) 827-2277 _ --(A/C No):(703) 827-2279
<br />--
<br />E-MAIL ADDRESS: ames ou admin� 9 9 h.com
<br />INSURERS) AFFORDING COVERAGE NAIC #
<br />-
<br />_INSURERA:National Union Fire Insurance Company— 19445
<br />INSURER B : Travelers Property Casualty Company of America 25674
<br />INSURER C : Continental Casualty Company (CNA) A, XV 20443
<br />INSURER D
<br />INSURER E :
<br />INSURER F :
<br />rn11P0Ar_GC r F:0TICIr'ATF IVI IIIARFD• DC\/I4ZIr1AI Ali I11ADCD-
<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 />INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br />LTR INSD WVD MM/DD YY MM DD/YYYY
<br />A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br />CLAIMS -MADE X OCCUR 3118633 3/31/2019 3/1/2020 DAMAGE TO RENTED 300,000
<br />X PREMISES (Ea occurrence) _ $_ _...
<br />MED EXP (Any one person) $ 25,000
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />GE_N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br />POLICY X PE O X LOC PRODUCTS - COMP/OP AGG $ 2,000,000
<br />OTHER: $
<br />A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br />(Ea accident)... _. _$u..
<br />X ANY AUTO 2446855 3/31/2019 3/1/2020 BODILY INJURY (Per person) $
<br />OWNED SCHEDULED -
<br />_ AUTOS ONLY AUTOS BODILY INJURY (Per accident) $
<br />—_ AUTOS ONLY AUUTOS ONLY _ (Per acdentDAMAGE $
<br />B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000
<br />EXCESS LIAB CLAIMS -MADE ZUP-31NIO602-19-NF 3/31/2019 3/1/2020 AGGREGATE $ 10,000,000
<br />DED X RETENTION $ 0 $
<br />A WORKERS COMPENSATION X PER STATUTE ORH
<br />AND EMPLOYERS'LIABILITY YIN 11326673 3/31/2019 3/1/2020 - 1,000,000
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
<br />OFFICER/MEMBER EXCLUDED? NIA
<br />(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />If yes, describe under 1,000,000
<br />DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
<br />C Professional Liab. AEH288355072 7/8/2018 7/8/2019 Per Claim/Aggregate 2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: Project #78392
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as additional insured with respect to General Liability
<br />when required by written contract. General Liability includes Additional Insured coverage for On -Going & Completed Operations as required by written
<br />contract. General Liability is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named
<br />insured and when required by written contract. 30-day Notice of Cancellation will be issued for the General Liability, Automobile Liability, Umbrella Liability,
<br />Workers Compensation and Professional Liability policies in accordance with policy terms and conditions.
<br />< EUNICE HEREDIA (PG I OF )
<br />City of Santa Ana
<br />20 Civic Center Plaza (M-30)
<br />PO Box 1988
<br />Santa Ana, CA 92702-1988
<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 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|