Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2016/09/30 LSA Associates, Inc. Certificate of Liability Insurance
Client#: 652 LSAASSOCI1 ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/08/2017 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 NAME: Julie L. Nelson Dealey, Renton &Associates A/cC, No, Ext : 510 465-3090 /�' No : 510 452-2193 P. O. Box 12675 E-MAIL ADDRESS: jnelson@dealeyrenton.com Oakland, CA 94604-2675 510 465-3090 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Hartford Fire Ins. Co. 19682 INSURED INSURER B : Trumbull Insurance Co. 27120 LSA Associates, Inc. INSURER C : Berkley Insurance Company 32603 E 20 Executive Park, Suite 200 Irvine, CA 92614 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: RFVISION NLIMRFR• 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. LT TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR 57CESOF4492 9/30/2016 09/30/2017 EACH OCCURRENCE $1,000,000 TO RENTED PREMDAMAGE ISES Eao. "ence s300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY -1 JECOT FILOC GENERAL AGGREGATE $2,000,000 X PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER: B AUTOMOBILE LIABILITY 57UUNIF1488 9/30/2016 09/30/2017 COMBINED SINGLE LIMIT Ea accident $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident)$ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N FFPROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? N / A 57WEGG5794 9/30/2016 09/30/201 SPER H- X A T O E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT 1 $1,000,000 DESCRIPTION OF OPERATIONS below C Professional AEC901319600 9/30/2016 09/30/2017 $2,000,000 per Claim Liability $4,000,000 Annl Aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) General Liability Policy excludes claims arising out of the performance of professional services. Project Name/Number: Goetz Road Widening Project/CIM1601B City of Menifee, and its officers, employees, agents, and authorized volunteers are named as Additional Insured as respects General Liability and Auto Liability coverage. Insurance is Primary/Non-Contributory per policy form wording. Waiver of Subrogation applies to Workers' Compensation. See attached endorsements. City of Menifee Attn: Carlos Geronimo 29714 Haun Road Menifee, CA 92586 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 ACORD 25 (2014/01) 1 of 1 #S1923327/M1828942 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AZM