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<br />.`off zo CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDIYYYY)
<br />1OM2D,9
<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 policy(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 insurance Services West, Inc.
<br />Los Angeles CA Office
<br />707 Wilshire Boulevard
<br />Suite 2600
<br />CONTACT
<br />PHONE FAX
<br />AR,. W.Eel; 0866) 2113-7122 AIC. No.: (800) 361-0105
<br />E-MAIL
<br />ADDRESS:
<br />INBURERIB)AFFOROING COVERAGE NAICa
<br />Los Angeles CA 90017-0460 USA
<br />INSURED
<br />INSURERA: Travelers Property Cas Co of America 25674
<br />willdan Homeland Solutions
<br />INSURER a: Lexington Insurance Company 19437
<br />2401 E. Katella Avenue, Ste. 220
<br />Anaheim CA 92806 USA
<br />INSURER C:
<br />NSURER D:
<br />INSURER E:
<br />EACHOCCURRENCt $1,000,000
<br />INSURER F:
<br />PREMISES Ea occurrence) E1, 000, 000
<br />COVERAGES CERTIFICATE NUMBER: b(UUr4U(tb43 NCVIJIUN NumooH:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown am as requested
<br />TIM LTR
<br />TYPE OF INSURANCE
<br />5
<br />POUCYNUMBER
<br />MUUOUGTLFF
<br />PULICYtAP
<br />UNITS
<br />X I COMMERCU LGEMERALUABIUTY
<br />P63073366586TIL
<br />EACHOCCURRENCt $1,000,000
<br />PREMISES Ea occurrence) E1, 000, 000
<br />-MADE X❑ OCCUR
<br />MED EXP (Any due Farina) $15,000
<br />TCLAVAS
<br />.E.X EmPbyee Benerds Liabary
<br />PERSONAL& ADV INJURY $1,000,000
<br />X radual Liabary Included
<br />GEN'LAGGREGATE LIMIT APPLIES PER.
<br />GENERALAGGREGATE $2,000,000
<br />X POLICY [:]PRCT E]LOC
<br />PRODUCTS -COMPIOPAGG $2,000,000
<br />e
<br />0
<br />OTHER
<br />A
<br />AUTOMOBILE LWBIUTY
<br />P -810 -7]36$332 -TIL -18
<br />11/09/2018
<br />11/09/2019
<br />COMBINED BINDLE LIMIT $1,000,000
<br />E acddem
<br />BODILY INJURY (Per person)
<br />X ANYAUTO
<br />2
<br />BODILY INJURY(Peracdden0
<br />OWNED SCHEDULED
<br />m
<br />AUTOS ONLY AUTOS
<br />R
<br />PeOPERTYDAMAGE
<br />NIFEOAVIOS NON.OWNED
<br />acmdenl
<br />ONLY AUTOS ONLY
<br />Y
<br />m
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />U
<br />AGGREGATE
<br />EXCESS LU1B
<br />H
<br />CLAIMS -MADE
<br />DED1 IRETENTION
<br />A
<br />WORKERSGOMPENSAMONAND
<br />PIUS9155881918
<br />11/09/2 18
<br />1 0
<br />19/ O1
<br />PER DTH.
<br />STATUTE
<br />EMPLOYERS' UABIUTYX
<br />YIN
<br />E.L. EACH ACCIDENT $1,000,000
<br />My PROPRIETOR/ PARTNER I EXECUTIVE N
<br />OFMCEWMEMBER E%CUAEOt
<br />(Mendamryin N1)
<br />NIA
<br />E.L.DISEASE-EAEMPLOYEE $1,000,000
<br />OESCRITION under
<br />OESCRIPRON un OPERATIONS below
<br />—_
<br />EL. D(SEASE.POLICY LIMIT $1,000,000
<br />B
<br />ArchitBEng Prof028174912
<br />11/09/2018
<br />11/09/2019
<br />Aggregate $2,000,000
<br />_
<br />SIR applies per policy ter
<br />s 6 Condi
<br />ions
<br />Per claim $1,000,000
<br />DESCRIPTION Of OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addifienal Panama Schedule, Ivy W stashed 11 mon space u required)
<br />RE: Grant Management.
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insured in
<br />accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability and
<br />7i1�
<br />Automobile Liability policies evidenced herein are Primary and Non -Contributory t0 other insurance available to an Additional
<br />insured, but only in accordance with the policy's provisions. A waiver of Subrogation is granted in favor of Certificate Holder
<br />in accordance with the policy provisions of the General Liability, Automobile Liability and workers' compensation policies.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City Of Santa Ana AUTHORIZED REPRESENTATIVE
<br />Attn: Clerk of the Council
<br />20 civic Center P1 dao (M-30)
<br />Santa Ana CA 92701 USA W_ . Ae.X✓C'tap.s. Y� fQ JL
<br />©1988.2015 ACORD CORPO Olights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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