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1 <br />CERTIFICATE OF LIABILITY INSURANCE <br />07/10/2018 <br />E!MATE(MM/DD/Y) <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 pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br />PRODUCER <br />AOn Risk Services Southwest, Inc. <br />Houston TX Office <br />CONTACT <br />NAME: <br />(A/cNN , Ext): (866) 283-7122 ac No ; (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />5555 San Felipe <br />Suite 1500 <br />Houston TX 77056 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />INSURERA: ACE American Insurance Company <br />22667 <br />wood Group USA, Inc. <br />fka Amec Foster Wheeler <br />17325 Park ROW <br />INSURERB: Agri General insurance Company <br />42757 <br />INSURERC: ACE Fire underwriters insurance co, <br />20702 <br />Houston TX 77084 USA <br />INSURER.D: AIG specialty insurance Company <br />26883 <br />-- - - <br />INSURERE: Lloyd's syndicate No. 2003 <br />AA1128003 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 570072245597 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 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. Limits shown are as requested <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />I POLICY -NUMBER <br />MMIDD/YYYY <br />MMIDD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />HDOG <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE [_X] OCCUR <br />DAMAGE TO RE= <br />PREMISES Ea occurrence <br />$2,000,000 <br />VIED EXP (Any one person) <br />$ 5 , 000 <br />PERSONAL& ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />GENERAL AGGREGATE <br />$4,000,000 <br />POLICY E PRO-❑ LOC <br />JECT <br />PRODUCTS • COMP/OPAGG <br />$4, 000, 000 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />ISA H25150132 <br />05/01/2018 <br />01/31/2019 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$2,000,000 <br />BODILY INJURY ( Per person) <br />, <br />X ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED AUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per accident <br />UMBRELLALIAB <br />EACH OCCURRENCE <br />EXCESS LIAB <br />HOCCUR <br />CLAIMS -MADE <br />AGGREGATE <br />DED RETENTION <br />A <br />B <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBEREXCLUDED? <br />(Mandatory In NH) <br />NIA <br />WLRC64625196 <br />Work Comp- ADS <br />WLRC64625202 <br />Work Comp- TN <br />05 01 2018 <br />OS/01/2018 <br />01 31 2 119 <br />01/31/2019 <br />X I PER STATUTE OTH. <br />ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />Ees 1.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />DESCRIPTdescnder <br />ION OF OPERATIONS below <br />I <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />E <br />Archit&Eng Prof <br />PSDEF1800726 <br />07/01/2018 <br />06/30/2019 <br />Any One Claim <br />$5,000,000 <br />SIR applies per policy terns <br />& condi I <br />ions <br />Aggregate Limit <br />$5,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />SEE ATTACHED ADDENDUM FOR ADDITIONAL NAMED INSURED AMEC COMPANIES. <br />Re: NPDES Inspection and Database Management and As -Needed services City of Santa Ana, its officers, employees, agents and <br />representatives are additional insured on the General Liability policy as required by written contract. coverage is primary and <br />non-contributory where required by written contract. <br />REVIEWED BY: EUNiCE HEREDiA (PG , OF , ) <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXP RATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />City of Santa Ana AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza <br />Santa Ana CA 92702 USA wQem <br />ilo le rlw, JL <br />01988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD <br />v <br />