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Digitally signed by Tori
<br />Tori Pierson Uu[:z0Z3.042714:47:42
<br />417-00
<br />``� �® CERTIFICATE OF LIABILITY INSURANCE
<br />DAE(MNVDDYYYY)
<br />Damnazz
<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 BELOW,
<br />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 />CONTACT
<br />ADD Risk Insurance Services West, Inc.
<br />Los Angeles CA Office
<br />PHONE (g66) 283-7122 PAX (800) 363-0105
<br />HOE Ext: Dec. Na.:
<br />707 Wilshire Boulevard
<br />EMAIL
<br />Suite 2600
<br />ADDRESS:
<br />Los Angeles CA 90017-0460 USA
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICA
<br />INSURED
<br />INSURERA: Zurich American Ins CO
<br />16535
<br />Tetra Tech, Inc.
<br />17885 Von Karman Ave
<br />INSURERS: American Guarantee & Liability Ins Co
<br />26247
<br />INSURERC: Lexington Insurance Company
<br />19437
<br />Irvine CA 92614 USA
<br />INSURER D: American International Group UK Ltd
<br />AA1120187
<br />NSURER E:
<br />INSURER f:
<br />COVERAGES CERTIFICATE NUMBER: 570092861827 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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
<br />INSR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INS,
<br />SUER
<br />Me
<br />POLICY NUMBER
<br />POLICY EFF
<br />10/01/2021
<br />POLICY EST
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERALLIABILITY
<br />Y
<br />Y
<br />GLO181740603
<br />10/01/2022
<br />EACH OCCURRENCE
<br />$2,000,00
<br />CLAIMS -MADE ❑X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES
<br />$1, 000,00
<br />X
<br />MED UP(my one Person)
<br />$10,000
<br />X.C,U Coverage
<br />PERSONALSADVINJURY
<br />$2,000,00
<br />GENIAGGREGATE LIMIT APPLIES PER
<br />GENERA -AGGREGATE
<br />$4,000,00
<br />POLICY EJELPR0.T Floc
<br />PRODUCTS -COMPIOP AGO
<br />$4, 000,00
<br />OTHER:
<br />A
<br />AUTOMOBILEWB1UTY
<br />Y
<br />Y
<br />BAP 1857085 03
<br />101011202110/01/2022
<br />COMBINED SINGLE LIMIT
<br />$S, D00,OD
<br />% AWAUTO
<br />BODILY IN.URY ( Per Parsenl
<br />OWNED SCHEDULED
<br />BODILY INJURY(Peraradent)
<br />ALTOS ONLY AUTOS
<br />HIRED AUTO. NON OWNED
<br />PROPERTY DAMAGE
<br />ONLY AUTOS ONLY
<br />Peracdtlenl
<br />O
<br />X
<br />UMBRELLA LIAR
<br />%
<br />OCCUR
<br />62785232
<br />10/01/2021
<br />10/01/2022
<br />EACH OCCURRENCE
<br />$10,000,00
<br />EXCESS UAB
<br />I CLAMS) AOE
<br />AGGREGATE
<br />$10,000,00
<br />DED I % RETENTION $100.000
<br />A
<br />WORKERS COMPENSATION AND
<br />Y
<br />WC254061603
<br />10/01/2021
<br />10/01/2022
<br />X
<br />I PER STATULE
<br />oTH
<br />B
<br />EMPLOYERSIIABILITY
<br />WC185708703
<br />10/01/2021
<br />10/01/2022
<br />ELEACHACCIDENT
<br />$1,000,00
<br />EXECUTIVE
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE N
<br />OEFlCEIrame BED E%CWnEn9
<br />NIA
<br />E L DISEASE -EA EMPLOYEE
<br />$1, OOO, 00
<br />In NH)
<br />Ers. describe order
<br />SCRIPTION OF OPERATIONS below
<br />E L DISEASE -POLICY LIMIT
<br />S1,000,000
<br />C
<br />Env Contr Prof
<br />028182375
<br />10/01/2021
<br />10/01/2022
<br />Each clain
<br />$5,000,00
<br />Prof/Poll Liab
<br />Agggregate
<br />$5,000,00
<br />SIR applies per policy terns
<br />& condi
<br />ions
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, AtltlNmal Re1mAs III nay be auzohed Nnwn apace Is no,dr id)
<br />RE: SA-2 Pressure Control Station Relocation and Transmission Main improvements. The City, its officers, officials, employees,
<br />and volunteers are included as Additional insured in accordance with the policy provisions of the General Liability and
<br />Automobile Liability policies. A waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy
<br />provisions of the General Liability, Automobile Liability and workers Compensation policies. Should any of the above described
<br />policies be cancelled before the expiration data thereof, the policy provisions will govern how notice of cancellation may be
<br />delivered to certificate holders in accordance with the policy provisions of each policy. General Liability evidenced herein i
<br />Primary to other insurance available to an Additional Insured, but only in accordance WIT th the policy provisions. Stop Gap
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana CA 92702 USA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOPCE WILL BE DELIVERED IN ACCORDANCE NTH THE
<br />POUCYPROVISIONS.
<br />AUTHORIZED REPRESENTAPVE
<br />M
<br />©1988-2015 ACORD CORPOF
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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