Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
PROOF OF INSURANCE (2015) CLOSED
C"� DATE (MMIDD/YY) I OF LIABILITY INSURAN3/19/2014 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 endorsements . PRODUCER NAM CONTACT Jerry Noyola Greyling Insurance Brokerage PHONE (770) 552 -4225 FAx (e66)550-40e2 450 Northridge Parkway FbmA'IL Jerry. noyolaCgreyling'.com Suite 102 INSURERS AFFORDING COVERAGE NAIC# Atlanta GA 30350 INSURERANational Union Fire Ins. Co. 19445 INSURED INSURER B:XL S ecialt Insurance Company 37885 Geosyntec Consultants, Inc. INSURERC:New Hampshire Insurance Com an 23841 900 Broken Sound Parkway NW INSURERD:Chartis Specialty Insurance Co. 26883 Suite 200 INSURER E: Boca Raton FL 33487 INSURER F: - -� COVERAGES CERTIFICATE NUMBER; 1.4 - 15 (Geosyntec Main) 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. INSR A L BR POLICY EF'F POLICY EXP LTR. TYPE OF INSURANCE POLICY NUMBER, (NMIA1920=1 NMI= YYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 000 X COMMERCIAL. GENERAL LIABILITY TED R NIM .$..._ 500,000 A CLAIMS -MADE OCCUR L 5302659 /1/2014 /1/2015 MED EXP (Any one person) $ - 25, 000 X Contractual Liabilit PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY LOC $ AUTOMOBILE LIABILITY U",wOMiB'INEO SINGLE LIMA rI ni 11000,000 A X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED A 6403892 (AOS) /1/2014 4/1/2015 BODILY INJURY (Per accident) $ A AUTOS NON OWNED A 6403893 (DSA) /1/2014 /1/2015 PROPERTY DAMAGE $ HIRED AUTOS AUTOS P r I X UMBRELLA LIAB X OCCUR EACH OCCURRENCE ''., $ 10, 000, 000 B EXCESS LIAB G CLAIMS -MADE AGGREGATE $ 10, 000, 000'. DED I X RETENTION$ 10,00q S00065764LI14A /1/2014 /1/2015 I$ (] WORKERS COMPENSATION C 015630620 (AOS) /1/2014 /1/2015 X WCSTATU- OTH- AND EMPLOYERS' LIABILITY YIN �iY L1A)IC ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT Is 1 000 000 A OFFICER/MEMBER EXCLUDED? �'' NIA C 015630621 (CA) /1/2014 /1/2015 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEEI 1 000 000 1! yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 D Professional Liability OPS 1951904 9/1/2013 /1/2015 Per Claim $8,000,000 Contractors Poll. Liab. Aggregate $10,000,00W DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Re: PSA - Stormwater Permit Compliance. The City of E1 Segundo, its officials & employees are named as Additional Insureds on the above referenced liability policies with the exception of workers compensation & professional liability where required by written contract. The above referenced liability policies with the exception of professional liability are primary & non - contributory where required by written contract. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, we will endeavor to provide 30 days' written notice (except 10 days for nonpayment of premium) to the Certificate Holder named below. CERTIFICATE HOLDER. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of E1 Segundo - Public Works ACCORDANCE WITH THE POLICY PROVISIONS. Stephanie Ratsouleas 350 Main Street AUTHORIZED REPRESENTATIVE E1 Segundo, CA 90245 David Collings /JERRY ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD