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Client#: 25326
<br />KPFFINCO
<br />AC,+R®,N CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br />03/25/2018
<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: It the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 any rights to the certificate holder In lieu of such endoreement(s),
<br />PRODUCER .NNE:.
<br />TACT
<br />Katie Krasner
<br />Grayling Ins. Brokerage/EPIC
<br />H 770.552.4225
<br />E E" Arc No :866.550.4082
<br />3780 Mansell Road, Suite 370
<br />MAIL
<br />ADDRESS: Katie.Krasner@greyling.c0m
<br />Alpharetta, GA 30022
<br />GL5268336
<br />4/01/2018
<br />INSURER(S)AFFORDING COVERAGE NAIL#
<br />INSURER A: NmlaneNnlon Piro Ino. Co. 19445
<br />WREMIBES Ee oca uP ace $500,000
<br />INSURED
<br />KPFF, Inc.
<br />INSURER B _Tm connnemm ecurmce company 35269
<br />1601 5th Ave
<br />INSURER C: Lmyaa of Lonean
<br />INSURER 0:
<br />.Suite 1600
<br />INSURER, E,
<br />Seattle, WA 98101
<br />PERSONAL &ADV INJURY $1.000,000
<br />INSURER Fl
<br />COVERAGES CERTIFICATE NUMBER: 18.19 REVISION NUMBER:
<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 CONTRACTOR 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 OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAIDCLAIMS.
<br />LTR
<br />TYPE OF INSURANCE
<br />INSH
<br />aH
<br />POLICY NUMBER
<br />MM B P
<br />MMI lY Y
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />7 CLAIMS -MADE ❑X OCCUR
<br />GL5268336
<br />4/01/2018
<br />04fD112019
<br />EEoAqCIdHp��OECCCrURRENCE $1000000
<br />WREMIBES Ee oca uP ace $500,000
<br />MED EXP (Anyone person) $25000
<br />PERSONAL &ADV INJURY $1.000,000
<br />_
<br />OEN'LAOGREIGAATTE LIMITAPPLIES PER:
<br />POLICY JECCT LOC
<br />GENERAL AGGREGATE $2000000-
<br />PRODUCTS- COMPIOP AGG $2 000 000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />CA9776930
<br />4/01/2018
<br />04/01/201
<br />S°zactleDSIN IT $1000,000
<br />X
<br />ANYAUTOBODILY
<br />INJURY (Per person) $
<br />_
<br />QUTOSDONLY AUT SULEO
<br />HIRED NON•OWNED
<br />AUTOGONLY AUTOS ONLY
<br />BODILY INJURY (Per accident) $
<br />PRO ER DAMAGE a
<br />Per could ent],,,,,,,,,,,,,,_
<br />B
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUfl
<br />6050399824
<br />0/1012017
<br />04101/201S
<br />EACH OCCURRENCE $10Q00000
<br />EXCESS LIAR
<br />CLAIMS -MACE
<br />AGGREGATE $10,000,000
<br />DED I X I RETENTION $0
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY
<br />ANVPROPRIETORIPARTNERIEXECUTIVE Y/N
<br />OFFIOOER/MEMBER EXCLUDEDY ®NIA
<br />(mandatory In NH)
<br />11 describe under
<br />OESa6RIPTION OF OPERATIONS below
<br />WCO22208245 AOS`
<br />( )PR
<br />WCO22298244(CA)
<br />4!01/2018
<br />4/01/201804/01/2Q1
<br />04/01/201
<br />X PER OTH-
<br />E.L. EACH ACCIDENT $1,000,000
<br />E.L; DISEASE -EA EMPLOYEE $1000000
<br />EL. DISEASE. POLICY LIMIT $1,000,000
<br />C
<br />Professional/
<br />80146LDUSA1704384
<br />0/1012017
<br />10/1012018
<br />Per Claim $10,000,000
<br />Pollution Llab.
<br />Aggregate $10,000,000
<br />SIR $260,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addlliomd Remarks Schedula, may be attached 11 more space to required)
<br />Re: Contract #s A-2015.175 & A-2016435 - Engineering Consultant Agreement; KPFF Job #1600031: The City of
<br />Santa Ana, its officers, employees, agents & representatives are named as Additional Insureds with respects
<br />to General Liability where required by written contract. Should any of the above described policies be
<br />cancelled by the issuing Insurer before the expiration date thereof, 30 days' written notice (exce It 10 days
<br />for nonpayment of premium) will be provided to the Certificate Hold
<br />REVIEWED RY. EUNICE HEREDIA.(I?C fOF, ,},_
<br />City of Santa Ana
<br />Clerk of the City Council
<br />20 Civic Center Plaza (M-30)
<br />P.O. Box 1988
<br />Santa Ana, CA 927021988
<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 />v4wf
<br />REPRESENTATIVE
<br />01988-2015
<br />ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S1023386/M1022304 KKRE1
<br />All rights reserved.
<br />
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