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ACOR& CERTIFICATE OF LIABILITY INSURANCE Ilia/ DATE (RAM DC YYYY) 1 1/3/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Bolton &Company CONTACT NAME: PHONE Exit 626799.7000 Fuc No: 626 583-2117 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 MAI' ADDRESS, INSURE 8 AFFORDING COVERAGE NAICe INSURER A: Greenwich Insurance Company 22322 www.boltonco.com 0008309 INSURED United Storm Water, Inc. 14000 East Valley Blvd. INSURER B: XL Insurance America, Inc. 24554 INSURER c: XLSpecialty Insurance Company 37865 INSURER 0: Indian Harbor Insurance Company 36940 City of Industry CA 91746 INSURER E NSURER F: COVERAGES CERTIFICATE NUMBER: 53408109 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NOR LTRAwwPOLICY TYPE OF INSURANCE ADDISUML NUMBER POLICY EFF POLICY UP LIMITS A CdiMERCIALGENERALLWILRY I IGEC3001234 112131/20191 12/31/2020 EACH OCCURRENCE $1000000 CLAIMS.MADE LVI OCCUR GAITIM To RENTED PREMISES Es acarrenoe $100000 MED EXP (Arty one Person) s $ 000 PERSONAL B ADV INJURY $1000000 GEWL AGGREGATE LIMIT APPLIES PER GENERALAGGREGATE $2,000,000 POLICY[V]JPEO �LOC PRODUCTS -COMPIOP ADD $2DD0000 $ OTHER B D AUTOMOBILELIABILRY AUTO AECO048938/ AECO048939 12/31/2019 12/31/2020 Ee BINEEDD SINGLE LIMIT $1 DDD DDD BODILY INJURY (Par Person) $ P,(ANY OWNED ASCHEDULED AUTOS ONLY UTOS BODILY INJURY (Par asadan) $ PROPERTY DAMAGE fps, e..want $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ C UMBRELLA LIAR OCCUR UECO048940 12(31/2019 12/31/2020 EACH OCCURRENCE $15000000 AGGREGATE $15 000 000 EXCESS LIAB CLAIMSaAAOE DED 1 RETENDON 10,000 $ - C WORKERS COMPENSATION AND EMPLOYERS' LI ARTI1' YIN ANYPROPRIETORIPARTNER/EXECUTNE OFFICERIMEMBEREXCLUDEDT NIA WEC3001235 12/31/2019 12/31/2626 PER STATUTE ER E.L EACH ACCIDENT $1 OOO OOO E.L DISEASE -EA EMPLOY f (MendetoryM NH) If yes, eascnde under DESCRIPTION OF OPERATIONS Ielm E.L. DISEASE -POLICY LIMIT $1000000 D Pollution Liability PECO048963 12/31/2019 12/31/2020 $15,000,000 Each Claim / $25,000 Ded. D Professional Liab - Claims Made PECO048963 12/31/2019 12/31/2020 $15,000,000 Each Claim / $25,000 Ded. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACCRD 101, Addll onal Ram aims SchadYN, may Ire attached N more space is required) GL Additional Insured applies per CG20100413 & CG20370413 attached, only if required by written contract/agreement- GL Primary & Non -Contributory Wording applies per XIL4240605 attached. Re: Agreement #A-2017-157 in City of Santa Ana. Excess Policy follows form. Additional Insured(s): City of Santa Ana, its officers, agents, volunteers and employees. Re: Agreement City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 ACORD 25 (2016103) 53400109 1 UNVTPUN 01 1 19-:0 all Linea SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2EVI WED &APPROVED p THORRED REPRESENTATIVE By RI MANAGEMENT DIVISION In VO LULU 01988-2015 ACC ACORD �� n name and logo are registered marks of ACORD All rights reserved.