KEN THOMPSON, INC. 1 - 2003 - Laserfiche WebLink

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CERTIFICATE a'.'r�,:.I'r9 PRODUCER Aon Risk Services OF INSURANCE DATE (MM/Y) 07,29,20042004 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, 1901 Main Street, Suite 300 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Irvine, CA 92614 (949) 608-6300 COMPANIES AFFORDING COVERAGE Ms. Kathy Ritch COMPANY A American Zurich Insurance Co. COMPANY B American Zurich Insurance Company INSURED 7 —1� Ken Thompson, Inc. A- � C��3 "-� / aL /�) LO MPgNY C C/o OCWD/OCSD COMPANY 10500 Ellis Ave. D Fountain Valley, CA 92708 COMPANY E COVERAGES THIS IS TO CERTIFY THAT 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. THE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, CO POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YYYY) DATE (MMIDD/YYYY) LIMITS B GENERAL LIABILITY GLO 3675577 01/07/2003 02/01/2006 Per Claim/Occ $ 2,000,000 X COMMERCIAL GENERAL LIABILITY General Agg $ 4,000,000 CLAIMS MACE [�] OCCUR Prod & Comp Opp Agg $ 4,000,000 OWNERS & CONTRACTORS PROTECTIVE Personal & Adv. Injury $ 2,000,000 Fire Damage $ 0 Medical Expense $ 0 AUTOMOBILE LIABILITY ANY AUTO APPROVED AS TCS FORM ALL OWNED AUTOS SCHEDULED AUTOS HIRED Auros 2 NON.OWNED AUTOS .4LL., _ AaslBlanL CILY.. ttorncy EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM A WORKERS COMPENSATION AND WC367-60-02-01 12/24/2003 12/24/2004 STATUTORY EMPLOYERS' LIABILITY EL Each Accident $ 2,000,000 THE PROPRIETORr X INCL PART NER$/EXECDTIVE OFFICIERS ARE. ExCL EL Disease Policy Limit $ 2,000,000 EL Disease Each Accident $ 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIRESTRICTIONSISPECIAL ITEMS Certificate holder is included as additional insured as respects Encroachment Permits &/or City Licenses for Ken Thompson, Inc. on the Groundwater Replenishment System — Unit I Pipeline Project. Additional Insured Endorsement CG2010 11/85 attached. CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 20 Civic Center Plaza EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Santa Ana, CA 92701 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON T E COMPANY, ITS AGENTS OR RfiftilESENTATIVES. AUTHORIZED R ENTATIVE Aon RL. rvices ACORD 25-S (3/88) PPR ei'.11309'04 fill 9:02