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Francine R. Villareal Villareal <br />i l ® <br />AC0/120 CERTIFICATE OF LIABILITY INSURANCE <br />I/l/2022 <br />uar:zon.os.ta te:n. -molt <br />DATE(MMIDDNYYY) <br />12/21/2020 <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 INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poiicy(ies) 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 rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER Lockton Companies <br />444 W. 47th Street, Suite 900 <br />Kansas City MO 64112-1906 <br />(816)960-9000 <br />CONTACT <br />PHONE FAX <br />No: <br />E-MAIL <br />ADDRESS, <br />INSURI AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Lexington Insurance Conipmy <br />19437 <br />INSURED TERRACON CONSULTANTS, INC. <br />1312893 <br />INSURER B : Travelers Property Casualty Co of America <br />25674 <br />INSURER C: The Travelers Indemnity Company <br />25658 <br />1421 EDINGERAVE., STE C <br />TUSTIN CA 92780 <br />INSURER D : <br />NSURERE: <br />NSURERF: <br />COVERAGES TERCO01 CERTIFICATE NUMBER: 15603400 REVISION NUMBER: XXX){XX,y <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. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MM/DDIYYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMBS <br />H <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />Y <br />N <br />TC2J-GLSA-1118L293 <br />1/1/2021 <br />1/1/2022 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />DAMAGE TO Ea oRENTED— <br />PREMISES unence <br />$ 1,000,000 <br />X <br />MED EXP (Any one person) <br />$ 25,000 <br />CONTRACTUAL LIAR <br />X <br />XCU COVERAGE <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY [X] jE T [� LOG <br />GENERALAGGREGATE <br />$ 4000000 <br />PRODUCTS-COMP/OPAGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />E <br />AUTOMOBILE <br />LIABILITY <br />Y <br />N <br />TC2J-CAP-131J3858. <br />1/1/2021 <br />1/1/2022 <br />COeBc dEDISINGLE LIMIT <br />$ 2 000 000 <br />X <br />BODILY INJURY (Per person) <br />$ )CyXXXX)c <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />N <br />BODILY INJURY (Peraccidenl) <br />$ XXXXXXX <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ XX 'i�Xxxx <br />$ )0Ck)= <br />UMBRELLA LIAB <br />OCCUR <br />NOTAPPLICABLE <br />EACHOCCURRENCE <br />$ )000XXxx <br />AGGREGATE <br />$ XX)x_�' <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ <br />$ xa)_XX <br />E <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE YIN <br />OFFICEWMEMBER EXCLUDED? <br />NIA <br />N <br />TC2J-UE-6N32541-0(ADS)) <br />TRK-UB-6N32384-6(AZ,MA,WI <br />1/l/2021 <br />I/l/2021 <br />1/l/2022 <br />1/1/2022 <br />PER OTH- <br />X STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1000000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />(Mandatory In NH) <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$ 1000000 <br />DESCRIPTION OF OPERATIONS below <br />A <br />PROFESSIONAL <br />LIABILITY <br />N <br />N <br />26010216 <br />1/1/2021 <br />I/1/2022 <br />$1,000,000 EACH CLAIM & <br />$1,000,000 ANNUAL AGGREGATE <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />RE: PROJECT # P60187197; PROJECT NAME: CITY OF SANTA ANA: HAZARDOUS MATERIALS SURVEYS AND REPORTS. CITY OF SANTA ANA, <br />ITS OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVE ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY, AUTO <br />LIABILITY AND UMBRELLA/EXCESS LIABILITY, THESE COVERAGES ARE PRIMARY AND NON-CONTRIBUTORY AS REQUIRED BY WRITTEN <br />CONTRACT. <br />15603400 <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />RISK MANAGEMENT DIVISION THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVIC CENTER PLAZA, 4TLI FLOOR ACCORDANCE WITH THE POLICY PROVISIONS. <br />SANTA ANA CA 92701 <br />AUTHORIZED REPRESENTA / <br />/ /y7 RiskMtllYgenuotfDisbem <br />1�1-! a. REVIEWED&APPROVEDBY: <br />©1988 615 ACORD C ) F'A . R. v:P&,Zd <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD RSk Management Analyst <br />