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Cllent0: 25320 <br />KIMLHORN <br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE <br />D TE 6120/2IDD/YYYY <br />/2azots <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. <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 endorsemern(s). <br />PRODUCER <br />Grayling Ins. Brokerage/EPIC <br />3780 Mansell Road, Suite 370 <br />Alpharetta, GA 30022 <br />cr Jerry Noyola <br />P"O" 770-5524225 <br />'AID NaEII: AIC No. 868.660.4082 <br />erry.noyola(Bgreyling.com <br />IN"ER AFFORDING COVERAGE <br />woes <br />NMUR A: National Union Fire In. Co. <br />19445 <br />INSURED <br />Kimley-Hom and Associates. Inc. <br />421 Fayetteville Street, Suite 600 <br />Raleigh, NC 27601 <br />INSURER a; Aspen American Insurance Company <br />43460 <br />INSURER Now Hampshire I-- CO. <br />541 <br />NSURERD:V%ns of London <br />08065202 <br />NSURERE: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 19-20 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />1N <br />` <br />TYPE OF INSURANCE <br />ADDL <br />NaR <br />Ua <br />nIPOLICY <br />NUMBER <br />ANVA <br />lDUTB <br />A <br />X <br />wirmcuGDENERALweurr <br />CWNSMAOE ❑X OCCUR <br />5268189 <br />D41011120119 <br />04/01/202 <br />EAAI;RAOoEcTc <br />f1 000000 <br />p� <br />BREMIBW E ,.,elr°wp, <br />f500000 <br />X <br />MEDE%P dn. <br />s25000 <br />Contractual Llab. <br />PERSONAL a AIN INJURY <br />f 1 00O 000 <br />LAGGREGATEUNITAPPLIESPER <br />POLICY E9JE�O Lee <br />GENERAL AGGREGATE <br />s2,000,000 <br />G <br />PRODUCTS-CONPIOPAGG <br />fCT <br />4000,000 <br />f <br />OTHER <br />A <br />AUTOMOBILE <br />X <br />LMNUTY <br />ANY TO <br />4489663 <br />MM112019 <br />890112020 <br />COMBI a D SINGLE LNITleaso0 <br />1 000 000 <br />EDGILY INJURY (Pal permnl <br />f <br />X <br />WHEDULED <br />AUTOS OS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY x AUTOS ONLY <br />EDGILY INJURY IParaotlEa,N) <br />f <br />PROPERTY DAMAGE <br />IPKWddan <br />f <br />f <br />B <br />U E LI LIAR <br />X <br />OCCLN <br />CX005FT19 <br />W0112019 <br />04101/2020 <br />EACH OCCURRENCE <br />$5,000,000 <br />AGGREGATE <br />f OOQ 000 <br />X <br />EXCESS I" <br />CLMMS4A GE <br />DED X RETP1mONS0 <br />f <br />C <br />A <br />WORNERSCOMPENSATION <br />AND EMPLOYERS' UAERITY YIN <br />ANY PROPRIETORIPARTNDED?ECUTNE <br />OFFICFO PRIETER ARTNEJ E <br />NIA <br />015893885 AOS <br />( ) <br />015893686(CA) <br />01/2019 <br />01120190"1/202 <br />04/011202 <br />X PER oTH' <br />EL. EACH ACCIDENT <br />$1000000 <br />El. DISEASE -SAE <br />00 f10000 <br />(NYaoonnadala,In NH) <br />OrOF OPERATIONS balm <br />EL.013EA9E-POIJCY LIMIT <br />$1000000 <br />D <br />Professional Llab <br />H0146LDUSA1904949 <br />112019 <br />04101/202 <br />Per Clalm 59,000,060 <br />Aggregate $2.000,000 <br />DESCRIPTION OFOPERATIONSILOCATIONS1VEMCLEStACORD1a1, Adtlltlonal Rama 9ahadUe,mry ba alarmed N mas sM" u MUNetl) <br />Re: On -Call Agreements A-2015.171, A-2017-108, A-2016-344, A-2017.273, A-2017-025, A-2009-212, A-2018-159 <br />01, A-2018-160-01 & A-2018-025. The City of Santa Ana, Its officers, employees, agents & representatives <br />are named as Additional Insureds with respects to General Liability where required by written contract. The <br />above referenced liability policies with the exception of workers compensation & professional liability are <br />primary & non-contributory where required by written contract. Separation of Insureds applies to the <br />(See Attached Descriptions) <br />City of Santa Ana <br />Risk Management Div <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />ACORD 25 (2016f03) 1 of 2 <br />#S1651322tNI1513917 <br />VED Lx APPRO E161.O ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />MANAC{EMFNT DIV I(3NE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />17 2020 1 AUTHORIZED REPRESENTATIVE <br />W .000-1v I o ,aa.vrtu a.vrt rv,w I H m. Pau ngnrs reserves. <br />The ACORD name and logo are registered marks of ACORD <br />111LOYAl <br />