|
Francine R. Digitally signed by
<br />Francine R. Ylanual
<br />Villareal Date: 2020.10.29095646
<br />-0 -DIX
<br />CERTIFICATE
<br />DAT1007/2202OWYY)
<br />OF LIABILITY INSURANCE
<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(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(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 />NAME:
<br />PHONE (g66) 283-7122 FAX (BOO) 363-0105
<br />INC. No. Ex4: pIC. No.:
<br />E-MAIL
<br />ADDRESS:
<br />Los Angeles CA 90017-0460 USA
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC tt
<br />INSURED
<br />INSURER A: Lexington Insurance Company
<br />19437
<br />Tetra Tech, Inc.
<br />17885 Von Karman Ave., Suite 500
<br />Irvine CA 92614 USA
<br />INSURER e: Zurich American Ins Co
<br />16535
<br />INSURER G American International Group UK Ltd
<br />AA1120187
<br />INSURER 0:
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 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 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 />LTq
<br />TYPE OF INSURANCE
<br />INSO
<br />WVO
<br />POLICY NUMBER
<br />MULICYLVV
<br />MIDDIV
<br />POLICYEXP
<br />MM,DI)yYYYd
<br />LIMITS
<br />B
<br />GLO
<br />EACHOCCURRENCE
<br />$1,000,000
<br />TXCCMWRCIALOE"2RALLIAB[LffY
<br />CIAIMS-MADE ❑X OCCUR_ffT
<br />RENTED
<br />PREMISES EamxED,U
<br />$1,000,000
<br />MED EXP(Any one person)
<br />$10,000
<br />Coverage
<br />PERSONAL &ACV INJURY
<br />$1,000,000
<br />GEN•LAGGREGATE LIMITAPPLIES PER:
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />POLICY X PRO X LOG
<br />JECT
<br />PRODUCTS - COMPIOP AGG
<br />$2,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />BAP 1857085 02
<br />10/01/20201010112021
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$5,000,000
<br />BODILY INJURY (Perperson)
<br />X ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTCB
<br />HIRED AUTOS NONOWNEDPROPERTY
<br />ONLY AUTOS ONLY
<br />BODILY INJURY (Per accident)
<br />DAMAGE
<br />Peracodenl
<br />C
<br />)(
<br />UMBRELLALIAB
<br />OCCUR
<br />62785232
<br />EACH OCCURRENCE
<br />$2,000,000
<br />EXCESS LIAR
<br />N
<br />CLAIMSMADEAGGREGATE
<br />.000, 000
<br />OEDI
<br />RETENTION
<br />B
<br />q
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR I PARTNER I EXECUTIVE
<br />OFFICERMEMBER EXCLUDED?
<br />(Model., in NH)
<br />It yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />WC254061602
<br />WC185709702
<br />10/01/2020
<br />10/01/2020
<br />10/01/2021
<br />10/01/2021
<br />X PER STATUTE OTH-
<br />ER
<br />EL EACH ACCIDENT
<br />$1,000,000
<br />EL.DISEASE-EA EMPLOYEE
<br />$1,000,000
<br />E. L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />A
<br />Env Contr Prof
<br />UZ81NZ375
<br />Prof/Poll Liab
<br />10/01/2019
<br />10/01/2021
<br />Each Clain
<br />Aggregate
<br />$1,000,000
<br />S2,000,000
<br />SIR applies per policy ter
<br />is & condi
<br />ions
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana, officers, agents, employees and volunteers are included as Additional Insured in accordance with the policy
<br />provisions of the General Liability policy as required by written contract. General Liability policy evidenced herein is
<br />Primary and Non -Contributory to other insurance available to Additional Insured, but only in accordance with the policy's
<br />provisions as required by written contract. Stop Gap coverage for the following states: OH, NO, WA, WY.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD My OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 civic Center Plaza
<br />Santa Ana CA 92702 USA
<br />019BB-2015 ACORD COF
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />Risk MmMgemgdDtt' I
<br />r(REVIEWED & APPROVED Br
<br />I i rMLNHr.[ f1. V�[LX�wL[
<br />�'.
<br />® Risk Management Malys[
<br />
|