SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A : NAIC #
NAME: CONTACT
(A/C, No): FAX
E-MAIL ADDRESS:
PRODUCER
(A/C, No, Ext): PHONE
INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR WVDADDL
INSD
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. $
$
$
$ PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person) COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEEE.L. EACH ACCIDENT EROTH- STATUTE PER
(MM/DD/YYYY) LIMITS POLICY EXP(MM/DD/YYYY) POLICY EFFLTR TYPE OF INSURANCE POLICY NUMBER INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $
$
OCCUR
CLAIMS-MADE DED RETENTION $
PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $
EACH OCCURRENCE $ DAMAGE TO RENTED
PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
9/15/2021
ABD Insurance & Financial Services
777 Mariners Island Blvd Suite 250
San Mateo, CA 94404 650-488-8565
www.theabdteam.com
Rod Sockolov
Cert Request
[email protected]
Accela, Inc.
2633 Camino Ramon
Suite 500
San Ramon CA 94583
63914379
✓
✓
City of Santa Monica is Additional Insured as respects General Liability but only to the extent required by written contract or written agreement.
City of Santa Monica
Its officials, officers, employees & volunteers
1685 Main Street, #110
Santa Monica, CA 90401
RE: All Operations of the Named Insured.
Waiver of Subrogation applies to Workers' Compensation. 1,000,000
1,000,000
10,000
1,000,000
2,000,000
2,000,000
1,000,000
Physical Dmg.Deductible 1,000
10,000,000
10,000,000
1,000,000
1,000,000
1,000,000
A ✓ 3604-91-08 9/1/2021 9/1/2022
✓
✓
A 7359-95-44 9/1/2021 9/1/2022
✓ ✓
A ✓ ✓ 7818-52-90 9/1/2021 9/1/2022
B 7175-62-53 9/1/2021 9/1/2022 ✓
N
C Errors & Omissions w/ Cyber EET 13707 01 9/1/2021 9/1/2022 Limit $5,000,000 per occurrence Limit: $5,000,000 Aggregate
Federal Insurance Company 20281
Chubb Indemnity Insurance Company 12777
Hudson Excess Insurance Company 14484
63914379 | 16254 | 21-22 All/E&O $5M | Patra (1) | 9/15/2021 2:41:04 PM (PDT) | Page 1 of 3 %HHMXMSREP -RWYVIH 7GLIHYPIH 4IVWSR 3V 3VKERM^EXMSR GSRXMRYIH
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9/15/2021
Accela, Inc.
9/1/2022
3604-91-08
09/01/2021
09/01/2021
63914379 | 16254 | 21-22 All/E&O $5M | Patra (1) | 9/15/2021 2:41:04 PM (PDT) | Page 2 of 3 %HHMXMSREP -RWYVIH 7GLIHYPIH 4IVWSR 3V 3VKERM^EXMSR PEWX TEKI
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63914379 | 16254 | 21-22 All/E&O $5M | Patra (1) | 9/15/2021 2:41:04 PM (PDT) | Page 3 of 3