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GILLS:PA-01 CABRALS <br />ACORO' <br />CERTIFICATE OF LIABILITY INSURANCE <br />DAE <br />T(M a DD/YYYY) <br />8/24/2011 <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: H the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain Policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s). <br />ISPRODUCER A Insurance Services Lice0E67768 <br />4350 Lm Jolla Village Drive, Suite 900 <br />San Diego, CA 921221 <br />NAMEONTA Sara Cabral <br />: <br />RE 619) 574-6220 FiO% 619) 574-6288 <br />ac No <br />A"pp^gL _ Sara.Cabral ioausa.com <br />INSURER(S) AFFORDING COVERAGE NAIC e <br />INSURER A : RLI Iris CO 13056 <br />INSURED <br />INSURER B: OneBeacon Arnerlca In6 CO 20621 <br />INSURER C : <br />Gillis S Panichapan Architects, Incorporated <br />I INSURER D : <br />2900 Bristol St. Suite G205 <br />Costa Mesa, CA 92626 <br />rINSUR.A. <br />INSURER F: <br />7/24/2011 <br />COVERAGES CERTIFICATE NUMBER: 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 VVITH 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 />/LTR <br />TYPE OF INSURANCE <br />The City of Santa Ana Attn: Michelle Walker <br />POLICY NUMBER <br />POLICY <br />PODGY EXP <br />UNITS <br />GENERAL UABILITY <br />EACH OCCURRENCE S 1.000.000 <br />A <br />tXc MMERCIAL GENERAL LIABILITY <br />CLAIM" MADE OCCUR <br />PSB0001119 <br />7/24/2011 <br />7/24/2012 <br />PREMISES Ea oeeurrenees 1.000,000 <br />MED EXP An vie erem S 10.000 <br />PERSONAL 6 ADV INJURY S 1.000.000 <br />GENERAL AGGREGATE S 2.000,00 <br />PRODUCTS-COMPIOP AGG S 2.000.000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRO LOC <br />POLICY F X JECT <br />S <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea ear Esnt S 1.000.000 <br />A <br />ANYAUTO <br />PSA000111B <br />6/1/2011 <br />6/1/2012 <br />BODILY INJURY (Par person) SALLOWNED <br />SCHEDULED <br />AUTOS <br />JX <br />BODILY INJURY (ParS <br />NON -O <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />ROPERTY DAMAGE S <br />(Per ecci e <br />S <br />X UMBRELLA U/1B X OCCUR <br />EACH OCCURRENCE S 1.000.000 <br />A <br />EXCESS UAB CLAIM8a,IADE <br />PSE0001038 <br />7/24/2011 <br />7/24/2012 <br />AGGREGATE s 1000.0 <br />OED I X I RETENTION <br />S <br />A <br />YVORICERS COMPENSATION <br />AND EMPLOYERS LIABILITYDRY <br />ANY PROPRIETOPVWNECu, YIN <br />Ww <br />OFFICER/MEMBER EXCLUDED, <br />NIA <br />PSW0001177 <br />9/1/2011 <br />9/1/2012 <br />X WC STATU- 0TH - <br />L� <br />E.L EACH ACCIDENT S 1.000.00 <br />E.L. DISEASE - EA EMPLOYEE S 1.000.000 <br />IMyaandal In NH) <br />DESCRIPTION OF OPERATIONS help+• <br />E . DISEASE - POLICY LIMIT S 1.000.000 <br />B <br />Professional Llab <br />DPLO33610 <br />11/8/2010 <br />11/8/2011 <br />Per Claim 1,000.000 <br />B <br />Ded. -$5.000 <br />DPL033610 <br />11/8/2010 <br />118/2011 <br />Aggregate 2,000.000 <br />DEseruPTWN OF OPERATIONS /LOCATIONS /VEHICLES (As.eh ACORD 101, waaalPnal Remsree 8eheduM, Nmws eyes la nqulreQl ��T�RU `J�� AS TO FORM <br />Re: All Operations of the Named Insured A Y <br />The City of Santa Ana Is additional Insured as respects qer rsl liability per the attached endorsement <br />aura Stitt S .dy �— <br />ASSiSlant City Attorney <br />IFICATE HOLDER <br />CA <br />C) 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />The City of Santa Ana Attn: Michelle Walker <br />AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza M-36 <br />PO Box 1988 <br />4 <br />Santa Ana CA 92702-19418 <br />C) 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />