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CERTIFICATE OF LIABILITY INSURANCE DATE(Mos/22//2e1901
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 cerliflcate holder Is ail ADDITIONAL INSURED, the pollcy(las) must have ADDITIONAL INSURED provisions or ba ondorsod.
<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 rights to the certificate holder In lieu of such endorsemont(S),
<br />PRODUCER CONTACT
<br />ONT Jennie Garcia
<br />The Empire Company PHONE PA
<br />U. qrc�`
<br />550 North Park Center Drive ADDREsst lgarola{aemplre-ae. om
<br />SUlte 205 INSURER(S)AFFORDING COVERAGE NAIC It
<br />Santa Ana CA 92705 tNBURERA; Ohio Sacudly Insurance Company 24082
<br />INSURED INSURER B: American Fire and Casually Insurance Company 24006
<br />Transportation Studies Inc INSURERC: United States Liability Insurance Company 26895
<br />2640 Walnut Ave Ste L INSURER D :
<br />Tustin CA 92780 1 INSURER F:
<br />non IMe Arr- r,rr innoro. 2019-2020 Master RPVIAIr1N NI IMRFR!
<br />v 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
<br />TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />LTR
<br />TYPE OP INSURANCE
<br />IN5D
<br />SU6R
<br />POLICY NUMBER
<br />MM/DD/YYYY
<br />MM/DDIYYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />1,000,000
<br />CLAIMS -MADE I —XI OCCUR
<br />DAMAGE OiSCFlfGI
<br />RE $ a cmi
<br />$ 500,000
<br />MED EXP (Any one person
<br />$ 16,000
<br />A
<br />BKS59050934
<br />10/01/2019
<br />10/01/2020
<br />PERSONAL aADVINJURY
<br />$ 1,000,000
<br />CTEN'LAM.ftEGATCLIMITAPPrrLIIE�ESSIPER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS • COMP/OP AGO
<br />2,000,000
<br />❑ PRO- E LOC
<br />POLICY JECT
<br />Expense Mod Factor 1
<br />$
<br />OTHER:
<br />Fn ecoc un NEO b NG IMiT
<br />$ 1,000,000
<br />AUTOMOBILE LIABILITY
<br />BODILY INJURY (Per person)
<br />$
<br />X ANYAUTO
<br />BODILY INJURY (Per accident)
<br />$
<br />A
<br />OWNED SCHEDULED
<br />BAS69050934
<br />10/01/2019
<br />10/01/2020
<br />AUTOS ONLY AUTOS
<br />HIRED NON -OWNED
<br />PROPERTY DAMAGE
<br />(Per gazldentj
<br />$
<br />AUTOS ONLY AUTOS ONLY
<br />Uninsured motorist
<br />$ 1,000,000
<br />X UMBRELLA LIAB OCCUR
<br />EACH~OCCURRENCE
<br />$ 1,000,000
<br />B EXCESSLIAB HCLAIMS-MADE USA59060934 10/01/2019 10/01/2020
<br />AGGREGATE
<br />$ 1,000,000
<br />DIED!� RErENTION $ 10,000
<br />$
<br />WORKERS COMPENSATION
<br />PER STATUTE ER
<br />AND EMPLOYERS' LIAO I LITY YIN
<br />A ANY PROPRIETOR/PARTNER/EXECUTIVE j`�i N/A XWS69050934 10/01/2019 10/01/2020
<br />EXCLUDCD7
<br />E.L.EACHACCIDENT
<br />$. 1,000,000
<br />1,000,000
<br />OFFICER/MEMBER
<br />(Mandatory In NH)
<br />E.L. DISEASE - EA EMPLOYEE
<br />$
<br />Ityesdesedbeunder
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 11000,000
<br />LIMIT
<br />$1,000,000
<br />C ERRORS & OMISSIONS SPI022743H 10/01/2019 10/01/2020
<br />DEDUCTIBLE
<br />$1,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Sohedulo, may be attached It more space Is required)
<br />Re; Agreement to Provide Traffic Counting Services on an On -Call Basis
<br />Tile City of Santa Ana, lis dRlcers, employees, agents, volunteers and representatives are named as additional Insureds with
<br />❑L 'E�jFD & A�]p�� II
<br />prlmarylnon-con
<br />wording In respect to the general liability Coverage per forms CG88100413 attached as required by written contract.
<br />By ISIC
<br />MANAGEMENT D
<br />09
<br />UANULLLAI I
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana, Risk Management Division, ACCORDANCE WITH THE POLICY PROVISIONS.
<br />4th Floor
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana CA 927024`"
<br />©1988.2016 ACORD CORPORATION, All rights reserved.
<br />ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />AL
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