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<br />Certificate of Insurance
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<br /> Agency Name and Address: THIS CERTIFICATE IS ISSUED AS A MATTER OF
<br />Professional Practice INFORMATION ONLY AND CONFERS NO RIGHTS UPON
<br />Insurance Brokers, Inc. THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
<br />10 California Street NOT AMEND, EXTEND OR ALTER THE COVERAGE
<br />Redwood City, CA 94063-1513 AFFORDED THE POLICIES LISTED BELOW.
<br /> Insureds Name and Address: Companies Affording Policies:
<br />Brown And Caldwell A Greenwich Insurance Company
<br />201 North Civic Drive, Suite 115 B.X L Specialty Insurance Company
<br />c.
<br />Walnut Creek, CA 94596 o.
<br /> E.
<br /> F
<br />
<br />COVERAGES: THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
<br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES.
<br />
<br />rVPE OF INSURANCE
<br />
<br />POLICY NUMBER
<br />
<br />EFF.DATE
<br />
<br />EXP.DATE
<br />
<br />A GENERAL LIABILITY GECOOO166203 03126103 03126104
<br /> IKI Commercial General Liability
<br /> D Claims Made
<br /> IKI Occurrence
<br /> D Owner's and Contractors
<br /> Protective
<br /> D
<br />A AUTO LIABILITY AECooOI66303 03/26/03 03126/04
<br />[jg Any Automobile
<br /> D All Owned Autos ~S TO Fe
<br /> D Scheduled Autos Al'dWVED RM
<br /> [jg Hired Autos IJJ" _,I,
<br /> ~ Non-owned Autos
<br /> D Garage Liability Vaur::l Slltt-dy
<br /> D ,.. ,
<br /> EXCESS LIABILITY
<br /> D Umbrella Form
<br /> D Other than Umbrella Form
<br />B WORKERS' WECoo14189 06/01/03 03/26104
<br /> COMPENSATION
<br /> AND EMPLOYER'S
<br /> LIABILITY
<br />A PROFESSIONAL PECoo000050 1 05131103 05/31/04
<br /> LIABILITY'
<br />
<br />POLICY LIMITS
<br />
<br />General Aggregate: $2,000,000
<br />Products-ComlOps
<br />Aggregate: $2,000.000
<br />Personal and Adv. Injury: $1,000,000
<br />Each Occurrence: $1.000,000
<br />Fire Dmg. (anyone fire): $1,000,000
<br />
<br />Combined Single Limit:
<br />Bodily Injury/person:
<br />Bodily Injury/accident:
<br />Property Damage:
<br />
<br />Each Occurrence:
<br />Aggregate:
<br />
<br />Statutory Limits
<br />Each Accident:
<br />Disease/Policy Limit:
<br />Disease/Employee:
<br />Per Claim
<br />A re ate
<br />
<br />$1,000,000
<br />$0
<br />$0
<br />$0
<br />
<br />$1,000,000
<br />$1,000.000
<br />$1.000,000
<br />$1,000,000
<br />$1,000,000
<br />
<br />$0
<br />
<br />Description of Operations/LocationsNehicles/Restrictions/Special items:
<br />ALL OPERATIONS OF THE NAMED INSURED. GENERAL LIABILITY ONLY: CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS, AND
<br />REPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS BUT ONLY AS RESPECTS LIABILITY ARISING OUT OF THE NAMED INSUREDS' OPERATIONS IN
<br />AS-NEEDED ASSISTANCE IN STORMWATER PLANNING, COMPLIANCE SERVICES, AND PRESENTATIONS OF SUCI-fMATERIAL TO THE CITY UPON REQUEST.
<br />ADDITIONAL INSURED ENDORSEMENT ATTACHED.
<br />'Written at a re ate limits of liabilil not less than amount shown,
<br />Certificate Holder: THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED
<br />WITHIN THE POliCY FOR ALL OPERATIONS OF THE INSURED.
<br />CANCELLATION:
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING COMPANY, ITS AGENTS OR REPRESENTATIVES WILL MAIL 30
<br />DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, EXCEPT IN
<br />THE EVENT OF CANCELLATION FOR NON-PAYMENT OF PREMIUM IN WHICH CASE 10 DAYS
<br />NOTICE WILL BE GIVEN.
<br />
<br />S-04, 0576
<br />City of Santa Ana
<br />Public Works Agency
<br />20 Civic Center Plaza-M36
<br />Santa Ana, CA 92701
<br />
<br />Authorized Representative:
<br />
<br />
<br />cc:
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<br />
<br />SEE
<br />
<br />05129103
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