|
t ' DATE(MM/DD/YYYY)
<br />ACORDTM CERTIFrCATE,,OF LIABILITY INSUIZAIYCE 09/26/2008
<br />PRODUCER
<br />Aon Risk Insurance Services West, Inc.
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
<br />fka Aon Risk Services, Inc. of S CA
<br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />707 Wilshire Boulevard
<br />CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
<br />Suite 2600
<br />COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Los Angeles CA 90017-0460 USA
<br />o
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />w
<br />PHONE- 866 283-7122 FAX- 847 953-5390
<br />INSURED
<br />INSURER A: National union Fire Ins Co of Pittsburgh
<br />19445
<br />Tetra Tech, Inc.
<br />INSURERB Insurance Company of the State of PA
<br />19429
<br />16241 Laguna Canyon Rd.
<br />a
<br />INSURER Lexington Insurance Company
<br />19437
<br />Irvine CA 92618 USA
<br />•p
<br />INSURER American International Specialty Lines
<br />26883
<br />INSURER E:
<br />1 7
<br />FHE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
<br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
<br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED
<br />INSR
<br />I,IR
<br />ADD'
<br />INSRD
<br />'I-l'PE OF INSURANCE
<br />POLICY NUMBER
<br />POLICY ITFECTIVE
<br />POLICY EXPIRATION
<br />LIMIT'S
<br />DAIF(MMVDDAYY)
<br />DA"1'F.(MMADDAYY)
<br />A
<br />GENERAL LIABILI I V
<br />CLI982538
<br />10/01/08
<br />10/01/09
<br />EACHOCCURRENCP"
<br />$1,000,000
<br />X CO;bI;AII(RCIAL(iENLRALLIABILI'TY
<br />DAMAGE PORLN'fED
<br />$1,000,000
<br />CLAIMS MADE. [!] OCCI IR
<br />PREMISES Qa occurencc)
<br />MED EXP (Anv one person)
<br />S100,000
<br />X X, C,U Coverage
<br />PERSONAL,&ADV 1_14Jl'RY
<br />$1,000,000
<br />N
<br />❑
<br />GENERAL A(iGRIiGKIE
<br />$Z , OOO, 000
<br />�
<br />GENT"MJGREGAI II 1 IMII' APPLIES PFR:
<br />PRODUCTS -COMP/OP A(iG
<br />$Z , OOO , OOO
<br />CD
<br />❑ POLICY X❑ PRO- ❑ LOC
<br />JECT
<br />A
<br />AUTOMOBILE LIABILITY
<br />CA8263140
<br />10/01/08
<br />10/01/09
<br />COMBINED SINGLE LIMIT
<br />p
<br />X ANY AUTO
<br />(Ea accident)
<br />$1,000,000
<br />z
<br />ALL OWNED AUTOS
<br />cl
<br />BODILY INJURY
<br />SCHEDULED AUTOS
<br />( Per person)
<br />4.
<br />X HIRED AUTOS
<br />U
<br />BODILY INJURY
<br />X NON OWNED AUTOS
<br />(Per accident)
<br />,
<br />C '
<br />PROPERTY DAMAGE
<br />�
<br />(Per accident)
<br />GARAGE LIABILITY
<br />AUTO ONLY - EA ACCIDENT
<br />ANY AUTO
<br />OTHER THAN EA ACC
<br />H
<br />AUTO ONLY
<br />AGG
<br />c
<br />EXCESS /UMBRELLA LIABILITY
<br />2213731
<br />10/01/08
<br />10/01/09
<br />EACH OCCURRENCE
<br />,
<br />OCCUR ❑ CLAIMS MADE
<br />AGGREGATE
<br />$5,000,000
<br />®DEDUCTIBLE
<br />RETENTION $50,000
<br />B
<br />B
<br />WORKERS COMPENSATION AND
<br />WC4
<br />WC4990697
<br />10/01/08
<br />10/01/08
<br />10/01/09
<br />XWC
<br />STATU-
<br />T T
<br />OTH-
<br />EMPLOYERS' LIABILITY
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />_
<br />ANY PROPRIETOR / PARTNER / EXECUTIVE
<br />_
<br />OFFICER/MEMBER EXCLUDED?
<br />E.L. DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />If yes, describe under SPECIAL PROVISIONS
<br />E.L. DISEASE -POLICY LIMIT $1, 000 , 000
<br />below
<br />COP51952583
<br />10/01/08
<br />Each slain $5,000,000
<br />r
<br />OTHER
<br />Prof/Poll Liab
<br />Contractor Prof
<br />Agggregate $5,000,000
<br />Deductible $250,000
<br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />RE: On -Call Engineering Design Services for water and Sewer Main Improvement Project The City of Santa Ana, 20
<br />Civic Center Plaza, Santa Ana, CA 92701, its officers, employees, agents, volunteers and representatives are
<br />included as Additional Insured as respects to General Liability as required by contract. coverage is Primary and
<br />-
<br />.
<br />City of Santa Ana - Public Works Agency
<br />Attn: Cesar E. Barrera
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDPA-11OR 49 MAIL
<br />r�
<br />As s t . Engineer 11
<br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />220 S. Daisy Avenue, M-85
<br />,. m.,,,,.�,T`1E;INSURE E*�
<br />Santa Ana CA 92702 USA
<br />OR
<br />Z=
<br />AUTHORIZED REPRESENTATIVE
<br />_Qex
<br />
|