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ACOROR, CERTIFICAVE OF LIABILITY INSURA CE ,�JStd�M°°" " <br />PRoeucey' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />h7elmsman insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />3 Woodfield Lakes HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />900 North National Parkway, Suite 300 .ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Schaumburg, IL 60173 INSURERS AFFORDING COVERAGE 1 NAICIf <br />N$URED <br />HNTB Corporation <br />200 E. Sandpointe Avenue, Suite 200 <br />Santa Ana, CA 92707 p <br />Fi—aJ <br />;ET.rrCUIzT.Ta.-1 <br />NSUTIEAC <br />Mutual Fire Insurance <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BFEN'SSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WI I RESPECT TO WHICH <br />THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />wSR iA00''...... POLICY NUMBER PCNACY EIDIAFFECT WE M CYE%PWATgN. <br />LIMITS <br />GEWRALLIAMLftt <br />EAC IOCCtIHf rNCE $ 1,000.000 <br />T82-141-433035-214 '. 1211/04 1211/05 <br />tVAMADB OOO./fO�O,b. <br />L COMME9CIALGEYFPY. 1 ASILITY t <br />PRLM� $n-aE, s <br />L _ {1tX:M$MADE QCCVR <br />MED c%ia Anr MP PQrypr,7 S 5,000 <br />PE PSONA( A A.w VNJSJA 1000,000_ <br />,$ <br />2,0 <br />CENFRALAGGRFfiATE S ,000 <br />f- <br />i GEN', Abh PE 'EJMI' Arvt1E$PER _ f <br />2-DM DUO <br />PdO04 GT5 COMP,pP AGO �$ _ _ <br />PUUCY (°PO LOC <br />AUiOM4HiLELY81lItY <br />8 AS2-141-433035-204 12/VO4 12/145 <br />COMA WEU 51hGLE NIt <br />tF=a,r demt $ 1000.000 <br />EX' ANY AV i J <br />': A.L ,WNEil AU R1S <br />I $CHF_11JLEOAutD$ <br />IPPr Ann+ei <br />--� <br />I, HIR'ef)AV iOS _ <br />@hC LviN,uRv i $ <br />1 _ NON CJW Yf.')4llTOS <br />(PP vW UIN1n <br />'. <br />I <br />PerPmnart} <br />GARAGE L14HILM <br />AUTCONLY -EA M]C O£NT $ <br />_ ANYAJTp <br />OTHrR THAN EA ACC <br />' f1LCESENMHRELLA UAHFLRY <br />AUTOUNLY. $$ <br />000.000 <br />( <br />!t, OGT,UP '.. CLAIMS MADE '.. <br />A4HOGP,IHAFM E t1 <br />i <br />A _ AUC9307638-02 12/1/04 ',.. 1ZI1105 <br />A..CREGATE 11,ODQ00O <br />RETENTION f <br />i Is <br />WORKERS COMPENSATION AND I — I/Ilm <br />W`. �J�— OTH <br />-Or's:DE <br />A EMPLOYEas LIABILITY WA Poll deductible endorsement With $250,000 deductible per <br />t,�ti _ _ _ <br />EACH A CCIoEIF ccrvr 1,000,000 <br />. ANv vRGPwETpnvnarxewExccuTtve <br />OFFICE0.TIEMHEP Ex CtUOED' OCQlRenCe(G3iIii5 (disease) With the (HOVIS#On that Liberty Mutual <br />l $ <br />r 00o'0UU <br />E [ O Sr ASE--- E <br />rc yea, L Will (may) advances payment of the deductible amoynt <br />------ EE, 3 <br />------ <br />I - -t;008;600--- <br />I PROVISIONS <br />AL PRpViSIQNS "ow <br />EL DGEASI, PUI%YLMIT 5 <br />OTMR <br />DESCNIP'DON OF OPERAI%NISILOCATONHt VEfRClE9/EXCLUSIONS ADDED SV ENDORgEMENT/SPEGUL PR0VK10NtI <br />HNTB Job 35421; On -Call Engineering Services Amendment to Agreement No. A-2001-170B Additional <br />Insured: City of Santa Ana, its <br />officers, agents, volunteers and employees as respects general liability. <br />City of Santa Ana <br />Public Works Agency <br />P.O. Box 1988, M-36 <br />Santa Ana, CA 92702 <br />(2001 MS) <br />SHOULD ANY OF ABOVE DESCMEO EOUdEb EE CANCELLED C[iORE TINE eYPMArci <br />1 <br />DATE iMMOF, rRe teful BOIMMA wu �Q DAYS NMITEM 1'f'�F3T.''i: �i5 "T<) F)�b't�TonrtcemxrcATEIaLDEnNAreoroTl�Lxn <br />.�.^ l IL 819iYTAiKitKit6GiKt.XOiK kK <br />aur,(i�Stltt Si.xJy <br />U TI <br />