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190090
<br />ACORO® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD IYYY)
<br />02/29/2012
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO UPON THE CERTIFICATE HOLDER. THIS
<br />�RIIIGHTS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AM� .4E.X�ELNT&Og�tTTB! ENOVE GE AFFORDED BY (S)THE POLICIES
<br />BELOW: THIS CERTIFICATE OF INSURANCE DOES NOT CON THE
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURE�SI the-poiiey(ies) must be, endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may requi I,aFt endorsement. A-statemeti) on this certificate does not confer rights to the
<br />Carl holder in lieu of such endorsements . - : ., ....., i._
<br />PRODUCER
<br />AO
<br />NAME' RoCio Leon
<br />John O_ Bronson Co. / #0425149
<br />3636 American River Drive Suite 200
<br />Sacramento, CA 95864
<br />- 916-480-4134 .vc No : 916-480.4134
<br />EMAIL
<br />ADDRESS: rleon(d)"ohnobroson.orn
<br />916-974-7800
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSu RER A: Financial Pacific Insurance Co (Sacramento, CA)
<br />INSURED Ware Disposal Inc.
<br />INSURER B : Princeton F—e$5 & Surplus WFI, Los Angeles, CA
<br />INSURER C : Alaska National Insurance Co (San Francisco, CA)
<br />P.O. BOX 8089
<br />NEWPORT BEACH, CA 92658
<br />INSURER D : Rockhill Insurance Com an WFI Los Angeles, CA
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />3UBRPOLICY
<br />POLICY NUMBER
<br />MMIODY EFF
<br />MM/DD EXP
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE 7x] OCCUR
<br />182323B
<br />2/28/12
<br />2/28/13
<br />DAMAGE TO RENTED
<br />PR MI
<br />$ 50,000
<br />MED EXP An one p.rson
<br />$ 5,000
<br />PERSONAL s ADV INJURY
<br />$ 1 .000,000
<br />A
<br />X $1,000 Per Occurrence PE) Ded.
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$ 2.000,000
<br />POLICY
<br />X PRO- LOC
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />182323B
<br />2/28/12
<br />2/28/13
<br />(E.— tlenl
<br />1 000 000
<br />BODILY INJURY (Per parson)
<br />$ALL
<br />AAUTOS
<br />OWNED SCHEDULED
<br />AUTOS
<br />$5,000 BI/PD Deductible
<br />BODILY INJURY (Per accid—)
<br />$
<br />p
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />Per..,.,[
<br />$
<br />X
<br />UMBRELLA LIAR
<br />OCCUR
<br />66A3UB000124700
<br />2/28/12
<br />2/28/13
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />B
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />(Lead Umbrella)
<br />DED I X I RETENTION$ 10,000
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />N / A
<br />11 HWS05450
<br />8/01/11
<br />8/01/12
<br />X WC STATU- IT"
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />D
<br />Excess Liability - 2nd Layer
<br />P-XSLTRU00009600
<br />2/28112
<br />2/28/13
<br />$5,000,000 Each Occurrence/$5,000,000 Agg
<br />TO FORM
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Sehatlula, If more space Is required) /
<br />RE: Work performed by the insured for certificate holder per written contract 2
<br />Add-1 City of Santa Ana; its officers, employees, agents, volunteers and representative _ _.;
<br />Interests: , Attorr.cr
<br />Forms: CG2010 021 OR
<br />L.CKIIr IGAIG AVLUCK t.:AN(-LCLLA l 1UN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City Of Santa Ana Public Woks Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Y S y ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 CIVIC CENTER PLAZA, M-21
<br />SANTA ANA, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />l
<br />© 1988-2010 ACORD CORPORATION. All rights reserved,' �!
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />1%
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