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ACORD <br />CERTIFICATE OF LIABILITY INSURAN <br />E <br />,~ <br />C <br />page 1 of 2 09/30/20D5 <br />PRODUCER 877-945-7378 THIS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />willia North America, Inc. - Regicnal cart Ceatar HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />26 Century Elvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P. O. Hox 305191 <br />Nashv111e, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED Tetra Tech, Inc. INSURERA: ACE American Inauraace Company 22667-011 <br />16291 Laguna Canyon Road <br />Suite M200 INSURER B: Coatiaeatal Casualty C an 20443-002 <br />Irvine, G 92618 INSURER C: Indemai ty Iaeuraace Company of North Amer 43575-001 <br /> INSURER D: Amerlcaa Iateraational Specialty Linea In 26883-000 <br />„„ e <br />A - L~5 ~ ~ <br />~ <br />1 INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />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 BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGR EGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />INBR DD' TYPE OFINfiUMNCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATON LIMRS <br />A X GENERAL LIABILITY 8DOG21724798 10/1/2005 10/1/2006 EACHOCCURRENCE $ 1 000 pp0 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br />PREMISES Es occurence <br />$ 1 OOO OOO <br /> <br /> CLAIMS MADE ®OCCUR MED EXP (Any one pereon) $ lOD OOO <br /> X COatraCt Liab. PERSONALS ADVINJURV $ 1 OOO OOO <br /> X Broad FOrm GENERAL AGGREGATE $ 2 DOD DDD <br /> <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2 OOO ODO <br /> POLICY X PRO LOC <br />$ AUT OMOBILE LIABILITY SIIA2074970365 10/1/2005 lO/1/2006 <br /> COMBINED SINGLE LIMIT <br />000 <br />$ 2 <br />000 <br /> X ANVAUTO (Ee aecitlent) , <br />, <br /> X ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Par person) S <br /> X HIRED AUTOS ~ BODILY INJURY <br />$ <br /> X NON-OWNED AUTOS (Per eccitlen0 <br /> `~~iCiVI PROPERTY DAMAGE <br /> A PI ~~~~1 '~ /i `1 il) <br />(PereccitlenQ $ <br /> <br /> GA MGE LUIBILRV AUTO ONLY-EA ACCIDENT $ <br /> ~ <br /> ANV AUTO ----'-'- OTHER THAN EA ACC S <br /> _- -.--:1 _ <br />i'i .`>t'- JI: 3; y AUTO ONLY: AGG $ <br /> EXCE66 LIABILITY (~, ~otS flD: [Y ~[i~' ~' ~- EACH OCCURRENCE $ <br /> <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br />A WORKERS COMPENSATION AND <br />' WI SCFC44335207 10/1/2005 10/1/2006 g wc$TATU- oTH- <br /> EMPLOYER6 <br />LIABILITY <br />C ANV PROPRIETORlPARTNEPJEXECUTIVE AOS YoLRC44335244 10/1/2005 10/1/2D06 E.L. EACH ACCIDENT $ 1 ppp DOD <br />A OFFICER/MEMBER EXCLUDED? P7LRC44335219 10/1/2005 10/1/2DO6 E.L. DISEASE-EA EMPLOYEE $ 1 QOO QOQ <br /> If yes, Describe uMer <br /> SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT $ 1 QQO DQD <br />D o7HER 000001952583 10 1 2005 10 1 2006 $5,000,000. Each Claim <br /> Ptofeeeicnal $8,000,000. Aggregate <br /> Pollution/E60 Legal Liab. $ 250,000. Retention Claim <br /> Nax. Claim duria alic ear <br />DE6CRIPTK)N OF OPERATIONSILOCATION6/VENIOLESrE%CLU610N6 ADDED BY ENDOR6EMENT/$PECIAL PROVISION6 <br />Re: San Lorenzo Sewer Lift Station <br />City of Santa Ana, its officers, agents, volunteers and representatives are named as Additional <br />Insured ae reapecta General Liability, as required by written contract. <br />Coverage is primary and non-contributory as reapecta General Liability, as required by written <br />contract. <br />CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DE6CRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ~Ifi70XX'EC MAIL 3 O DAYS WRITTEN <br /> NOTCE TO THE CERTIFICATE HOLDER NAMED TO THE LE L <br />City of Santa Aaa YeNdG1f1G1DONCfdWtffiICYilCXIXffi0[SF7f1DIX$70ydC~7pL'1(df~9Cy~C <br />Public Works Agency <br /> <br />Attn: Steve Worrell ~ <br />220 S. DEisy AVealle AUTH ESENT~TIVE <br />Santa Aaa, G 92703 /~ <br />ACORD 25 (2001/08) Co11:1416960 Tp1:415118 Cert:6256/413 ®ACORD~ORPORATION1988 <br />