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Francine R. Digitally signed by Francine R.
<br />Villareal
<br />Villareal Date: 2021.03.23 10:52:03 -07'00'
<br />"u �® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/D0/YYYY)
<br />03/WDDf1
<br />1
<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 />ADD Risk Insurance services West, Inc.
<br />Los Aneles CA Office
<br />g
<br />707 Wilshire Boulevard
<br />Suite 2600
<br />CONTACT
<br />NAME:
<br />PHO
<br />(NC. No. ExU: (866) 283-7122 FAX (800) 363-0108
<br />NC. No.:
<br />E-MAIL
<br />ADDRESS:
<br />Los Angeles CA 90017-0460 USA
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC ft
<br />INSURED
<br />INSURER A: Travelers Property Cas Co of America
<br />25674
<br />willdan Engineering
<br />2401 East Katella Avenue
<br />INSURER B: Lexington Insurance Company
<br />19437
<br />INSURER C:
<br />Suite 300
<br />Anaheim CA 92806 USA
<br />INSURER 0:
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES UCH I 1111: NUMLI D7ULN364bB886 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 />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />Mo
<br />POUCYNUMBER
<br />MM19DDIYYYY
<br />MMIDD/YYYY
<br />LIMITS
<br />MMERCIAL GENERAL LIABILITY
<br />TIL
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS MADE ❑X OCCUR
<br />TXEomoyoo
<br />PREMISES Ea occurrence
<br />$1,000,000
<br />MED EXP (Any one person)
<br />$15,000
<br />Benefits Liability
<br />ntractual Llablllty Included
<br />PERSONAL&ADV INJURY
<br />$1,000, 000
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />GENERALAGGREGATE
<br />$2,000,000
<br />X POLICY PRO-
<br />JECT LOG
<br />PRODUCTS - COMP/OP AGG
<br />$2,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE LIABILITY
<br />810-7N676545-20-43-G
<br />11/09/2020
<br />11/09/2021
<br />COMBINED SINGLE LIMIT
<br />Ea moment
<br />$1,000,000
<br />BODILY INJURY (Par person)
<br />% ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED AUTOS NON -OWNED
<br />ONLY AUTOS ONLY
<br />BODI LY INJURY(Per accident)
<br />PROPERTY DAMAGE
<br />IPeraccidenl
<br />UMBRELLALIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />EXCESS LIAB
<br />CLAIMS MADE
<br />AGGREGATE
<br />DEO RETENTION
<br />A
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? Fq
<br />(Mandatory In NH)
<br />DESCRIPTION OF OPERATIONSbelow
<br />N/A
<br />UBOL66367 2043G
<br />11 09 2020
<br />11 09 2021
<br />X PERSTATUTE OTH
<br />ER
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />B
<br />Archit&Eng Prof
<br />028174912
<br />SIR applies per policy terns
<br />11/09/2020
<br />& condi
<br />11/09/2021
<br />ions
<br />Aggregate
<br />Per Claim
<br />$2,000,000
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required)
<br />RE: To provide engineering services on an as -needed basis. Engineeringg services may include, but are not limited to, civil
<br />engineering, electrical engineering, traffic engineering, geotechni calr land/property surveying, structural, architecture and
<br />landscaping design services and grant writing services. General LiabilT ty policy excludes claims arising out of the performance
<br />of professional services. Independent Contractors are included as respects to General Liability.
<br />City of Santa Ana, officers, agents, employees, and volunteers are included as Additional Insureds in accordance with the
<br />policy provisions of the General Liability, and Automobile Liability policies. General Liability, and Automobile Liability
<br />evidenced herein are Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance
<br />�y
<br />U
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />3
<br />x-
<br />SHOULD ANY OF THE ABOVE DESCRIBEDPOLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICEICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City Of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th floor
<br />Santa Ana CA 92702 USA
<br />AUTHORIZED REPRESENTATIVE
<br />tYfXYP/ ✓Ur
<br />A��'
<br />RlekManyt;anmtDlvtalon
<br />©1988-2015 ACORD CO
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />� 2.�
<br />REVIEWED&APPROVEDB'f:
<br />I "F - Z Vw
<br />�^---�---" Riik Management Analyst
<br />
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