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A-2017-223 & A-2017-364
<br />A 2z11`I 2-Z3
<br />HOUS&HA-01 SMARTIN
<br />Av CERTIFICATE OF LIABILITY INSURANCE
<br />DA8291 DD/YYVY)
<br />8129/2017
<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 endorsernor ).
<br />PRODUCER License # OC36861
<br />Inland Empire-Alliant Insurance Services, Inc.
<br />735 Carnegie Dr Ste 200
<br />San Bernardino, CA 92408
<br />CONTACT Stacy Guillen
<br />NAME
<br />PHONE FAX
<br />A/c No Ext : (909) 886.9861 Alc, Nu: (909) 886-2013
<br />AIL
<br />ADDB s: SGuillen@alliant.com
<br />INSURER(5) AFFORDING COVERAGE
<br />NAIC N
<br />INSURER A: Ifonshore Specialty Insurance Company
<br />25445
<br />INSURED
<br />Houston & Harris P C S Inc
<br />21831 Barton Road
<br />Grand Terrace, CA 92313
<br />INSURER e: Nationwide Mutual Insurance Company
<br />23787
<br />INSURER C : RSUI Indemnity Company
<br />22314
<br />INSURER 0: Cypress Insurance Company
<br />10855
<br />INSURER E : Landmark American Insurance Company
<br />33138
<br />NSURER F
<br />CfTVF'RAQFR CFDTIFICATD MIIMRFD- 0F1110]AM Mt IAaRFD.
<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
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />MO
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MMIODrrYYY
<br />LIMITS
<br />A
<br />MERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,00CLAIMS-MADE
<br />*XCO�
<br />� OCCUR
<br />X
<br />AGS0027605
<br />06/24/2017
<br />06/2412018
<br />PREMISES Eaoccunence
<br />$ 50,000
<br />MEDEXP(Anyoneperson)
<br />$ 5,00
<br />Di per Occ.
<br />PERSONAL& ADV INJURY
<br />$ 1,000,00
<br />GENT
<br />AGGREGATE LIMITAPPLIES PER:
<br />Y LOC
<br />POLICJE�
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMP/OP AGO
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident)
<br />$ 1,000,000
<br />B
<br />X
<br />ANYAUTO
<br />ACP3036645740
<br />06/2412017
<br />0612412018
<br />BODILY INJURY person)
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS OS
<br />AUT
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />NON -OWNED
<br />HIREDAUTOS X AUTOS
<br />PROPERTY DAMAGE
<br />Per accident)
<br />$
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 4,000,00
<br />X
<br />AGGREGATE
<br />$ 4,000,00
<br />C
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />NHA242820
<br />0612412017
<br />06/2412018
<br />BED
<br />I X RETENTION$ 6
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED? ❑
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />X
<br />HDWC807872
<br />09/01/2017
<br />0910112018
<br />X PER TH-
<br />STATUTEER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,00
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,00
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,00
<br />E
<br />Prof. Liability
<br />LHR832189
<br />06/2412017
<br />0612412018
<br />AgglEach Claim Limit 2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Job: Operations pertaining to named insured for Certificate Holder.
<br />City of Santa Ana is Additional Insured as respects to General Liability per endorsement attached. Waiver of Subrogation applies as respects to worker's
<br />compensation per endorsement attached.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza M-16
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />i JL41,
<br />PJ
<br />r
<br />©1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
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