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<br />HARRAND.{)l AFDI
<br />
<br />PRODUCER
<br />Diversified Risk/Hub International
<br />License #0757776
<br />400 Taylor Blvd., Suite #300
<br />Pleasant Hill, CA 94523
<br />
<br />(800) 877 -4560
<br />
<br />DATE (MMlDDIYYYY)
<br />8/5/2008
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POUClES BELDW.
<br />
<br />ACORD,.
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />INSURED
<br />
<br />Harris & Associates Inc.
<br />Attn: Susan Mandilag
<br />120 Mason Circle
<br />Concord, CA 94520
<br />
<br />
<br />-;q
<br />
<br />INSURERS AFFORDING COVERAGE
<br />INSURER A: OneBeacon America Insurance CO.
<br />URER e. Hartford Fire Insurance CO.
<br />INSURERC- American Guarantee & Liabili
<br />INSURER D- Alaska National Insurance Com an
<br />INSURER E: Colon National Insurance Com an
<br />
<br />NAlC#
<br />
<br />4-
<br />A 2007-oS5
<br />
<br />COVERAGES
<br />
<br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHS
<br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED
<br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS 0
<br />~S AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />IN POLlCY NUMBER POLICY EFFECTIVE POLICY EXPlRA TION LIMITS
<br /> ~NERAL. LIABILITY EACH OCCURRENCE , 1,000,00
<br />A X -.! jMERCIAL GENERAL LIABILITY 718009690-0002 8/1/2008 8/1/2009 ~~~~~~~E~~~nce , 1,000,00
<br /> """':"":" CLAIMS MADE [K] OCCUR t..ED EXP (AAj one persm l , 10,00
<br /> X "X""C""U" PERSONAL &ADVINJURY , 1,000,00
<br /> X Severability of Interest GENERAL AGGREGATE , 2,000,00
<br /> -~~l'~ Aa3~Eril ~IMIT APrl ~ER PRODUCTS. COMP!OP AGG , 2,000,00
<br /> POLICY X ~ LOC
<br /> ~TOMOBlLE LIABILITY COMB1NED SINGLE LIMIT I 1,000,00
<br />B X ~ ANY AUTO 57UENUL6878 8/1/2008 8/1/2009 (Eaao:::idel1l)
<br /> - ALL OV\INED AUTOS . o fO"l\1J\ BODILY INJURY
<br /> I
<br /> SCHEDULED AUTOS N?? p.$( ~> (Per-person)
<br /> X HIRED AUTOS p.??r BODILY INJURY
<br /> X (PeraCCld$1I) I
<br /> -"- NON-OWNED AUTOS - ;;.. Jf'..C'f..
<br /> P. 'T'-_ Si PROPERTY DAMAGE
<br /> -\.\Sf>- "'....,,' f>-\to'''~'' (Peracci6enl) S
<br /> ~~E '''.,UTY f>-SS\S\a'" AUTO ONLY - EA ACCIDENT $
<br /> ANY AUTO OTHER THAN EAACC ,
<br /> AUTO ONLY AGG ,
<br /> EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE I 1,000,000
<br />C ~-OCCUR 0 CLAIMS MADE ~UC9305561-06 8/1/2008 8/1/2009 AGGREGATE I 1,000,000
<br /> ,
<br /> =i ~EDUCTl"E I
<br /> RETENTION I ,
<br /> WORKERS COMPENSATION AND X IT~~JN~; I IOJ~-
<br />D EMPLOYERS' LIABILITY 08WHD40007 8/1/2008 8/1/2009 1,OOO,OOC
<br /> E.L. EACH ACCIDENT I
<br /> ANY PROPRIETORJPARTNER'EXECUTIVE l,OOO,OOC
<br /> OFFICER/MEMBER EXCLUDED? E L DISEPSE - EA EMPLOYEE I
<br /> ~WC~~~~NS below E.L. DISEASE - POLICY LIMIT I 1,000,00<
<br /> OTHER
<br />E Excess Liability AR6460401 8/1/2008 8/1/2009 10,000,000 excess 1,000,000
<br />DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL. PROVISIONS
<br />n the event of cancellation for non-payment of premium, a 10 day notice will apply. Evidence of PROFESSIONAL L1AB on following page.
<br />Re: Bristol Street Widening Project - Phase I (A-2006-192) (H&A #062-0412.01)
<br />The City of Santa Ana, Its officers. employees, and representatives are named as additional insured (Gen. & Auto Liab.), if required by
<br />written contract/agreement. per attached One Beacon America Additional Insured endorsement, and CA2048 0299.
<br />
<br />CERTlFICA TE HOLDER
<br />
<br />CANCELLATION
<br />
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />City of Santa Ana DATE THEREOF, THEISSUINGINSURERWIL~.J0MAIL 3...D......- DAYSWRmEN
<br />Clerk ofthe City Council NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B)(JO)(K*)(o(~DeC:L
<br />20 Civic Center Plaza (M-36) ~~__Dl~IIIl(XX~
<br />Santa Ana, CA 92701-
<br /> AUTHORIZED REPRESENTATIVE ....<D--~ ~.
<br /> .....-..
<br />
<br />ACORD 25 (2001108)
<br />
<br />@ACORDCORPORATION1988
<br />
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