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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DAT 1013112017VVY)
<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 pohcy(ies) 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($).
<br />PRODUCER
<br />ADD Risk Insurance services West, Inc.
<br />LOS AM19eles CA Office
<br />CONTACT
<br />NAME:
<br />INC. NNo. Ext): (866) 283-7122 ac. No.: (800) 363-0105
<br />707 Wll shire Boulevard
<br />Suite 2600
<br />E-MAIL
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE NAIC At
<br />LOS Angeles CA 90017-0460 USA
<br />INSURED
<br />INSURERA: Travelers Property Cas CO Of America 25674
<br />Willdan Homeland Solutions
<br />2401 E. Katella Avenue, Ste. 220
<br />INSURER B: Lexington Insurance Company 19437
<br />INSURER C:
<br />Anaheim CA 92806 USA
<br />INSRER UD:
<br />/y"a �a1G
<br />NSURER E:
<br />92701 USA
<br />INSURER F:
<br />PREMISES Es ocavenca $1,000,000
<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 />IVSD
<br />ME
<br />POLICY NUMBER
<br />MMIODIVYYY
<br />MMIDOIYVYY
<br />LIMITS
<br />A
<br />M MERCIAL GENERAL LIABILITY
<br />AUTHORIZED REPRESENTATIVE
<br />TTL
<br />of the City Council
<br />EACH OCCURRENCE $1,000,000
<br />20 Civic Center
<br />PO Box 1988
<br />CLAIMS -MADE ❑X OCCUR
<br />#CO
<br />�•'r �rsaaW
<br />/y"a �a1G
<br />Santa Ana CA
<br />92701 USA
<br />t/G�faAYla
<br />PREMISES Es ocavenca $1,000,000
<br />MED EXP (Any one person) $15,000
<br />mployee Benefits Liability
<br />PERSONAL a ADV INJURY $1,000,000
<br />GEWL AGGREGATE LIMITAPPLIES PER:
<br />GENERAL AGGREGATE $2,000,000
<br />X POLICY ❑ PRO ❑ LOC
<br />ECT
<br />PRODUCTS -CONFIDE AGO $2,000,000
<br />OTHER.
<br />A
<br />AUTOMOBILE LIABILITY
<br />BA -7]365332 -TIL -17
<br />11/09/201711/09/2018
<br />COMBINED SINGLE LIMIT $1,000,000
<br />Ea accitlem
<br />BODILY INJURY( Per person)
<br />X ANYAUTO
<br />BODILY INJURY (Per accident)
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED AUTOS NON -OWNED
<br />ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per acatlenf
<br />UMBREL-ni
<br />OCCUR
<br />EACH OCCURRENCE
<br />AGGREGATE
<br />EXCESS UAB
<br />CLAIMS -MADE
<br />DED
<br />RETENTION
<br />A
<br />WORKERS
<br />EMPLOYERS' ION AND Y N
<br />ANY PROPRIETOR/ PARTNER I EXECUTIVE
<br />U69]$58819TI L17
<br />11/09/2017
<br />11/09/2018
<br />X STATUTE ETH
<br />E.L. EACH ACCIDENT $1,000,000
<br />OF I GERIMEMBER EXCLUDED] N
<br />(Mandatory in NH)
<br />NIA
<br />E.L. DISEASE -EA EMPLOYEE $1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />B
<br />Archit&Eng Prof
<br />028174912
<br />11/09/2017
<br />11/09/2018
<br />Aggregate $2,000,000
<br />SIR applies per policy ter
<br />s & condi'lons
<br />Per Claim $1,000,000
<br />SIR $250,000
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is requlrad)
<br />RE: Grant Management Services. City of Santa Ana, its officers, employees, agents, volunteers and representatives are
<br />included as Additional Insured with respect to the General Liability and Automobile Liability policies; and the General
<br />Liability policy evidenced herein is Primary and Nan -Contributory to other insurance available, in accordance with the policy
<br />provisions. Severability of Interests coverage is included within the General Liability policy,
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />©1988.2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016105) The ACORD name and to o are registered marks of ACORD
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
<br />CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
<br />IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City Of Santa
<br />Ana
<br />AUTHORIZED REPRESENTATIVE
<br />Attn:Clerk
<br />of the City Council
<br />20 Civic Center
<br />PO Box 1988
<br />P1 aza(M-30)
<br />�•'r �rsaaW
<br />/y"a �a1G
<br />Santa Ana CA
<br />92701 USA
<br />t/G�faAYla
<br />©1988.2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016105) The ACORD name and to o are registered marks of ACORD
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