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ACOR CERTIFICATE OF LIABILITY INSURANCE
<br />M/DD/YY)
<br />8 /13
<br />08/13/07
<br />PRODUCER 1- 866 - 220 -4625
<br />Holmes Murphy and Associates - Omaha
<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 />2637 South 158th Plaza
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Suite 200
<br />POLICY EFFECTIVE
<br />Omaha, NE 68130
<br />INSURERS AFFORDING COVERAGE
<br />INSURED
<br />Post, Buckley, Schuh & Jernigan, Inc.
<br />d /b /a PBS &J
<br />INSURER A: Steadfast Insurance C any/ #26387
<br />INSURERB:Zurich American Insurance Company/ #16535
<br />INSURERC:Zurich American Insurance Company / #16535
<br />2001 NW 107th Avenue
<br />INSURER D:
<br />Miami, FL 33172 -2507
<br />INSURER E:
<br />$ 1,000,000
<br />nnvco A r_oc
<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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />POLICY EFFECTIVE
<br />POLICY EXPIRATION
<br />LIMITS
<br />B
<br />GENERAL LIABILITY
<br />GLO 9139458 -00
<br />09/30/06
<br />09/30/07
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />FIRE DAMAGE (Any one fire)
<br />$ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS MADE Fx-I OCCUR
<br />MED EXP (Any one person)
<br />$ 25,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />X Contractual Liability
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />_
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP /OP AGG
<br />$2,000,000
<br />POLICY X1 PRO X LOC
<br />C
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />BAP 9139457 -00
<br />BAP 9139486 -00
<br />09/30/06
<br />09/30/06
<br />09/30/07
<br />09/30/07
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$2,000,000
<br />X
<br />BODILY INJURY
<br />(Per person)
<br />$
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />X
<br />BODILY INJURY
<br />(Per accident)
<br />$
<br />HIRED AUTOS
<br />NON -OWNED AUTOS
<br />•
<br />•
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />Contractual Liability
<br />GARAGE LIABILITY
<br />AUTO ONLY - EA ACCIDENT
<br />$
<br />OTHER THAN EA ACC
<br />$
<br />ANY AUTO
<br />$
<br />AUTO ONLY: AGG
<br />A
<br />EXCESS LIABILITY
<br />AUC 508762102
<br />09/30/06
<br />09/30/07
<br />EACH OCCURRENCE
<br />$ 25, 000, 000
<br />X OCCUR EI CLAIMS MADE
<br />AGGREGATE
<br />$ 25, 000, 000
<br />$
<br />DEDUCTIBLE
<br />$
<br />RETENTION $ 0
<br />B
<br />WORKERS COMPENSATION AND
<br />WC 9139459 -00
<br />09/30/06
<br />09/30/07
<br />X WCSTATU- OTH-
<br />EMPLOYERS' LIABILITY
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />-
<br />E.L. DISEASE - POLICY LIMIT
<br />I $ 1, 000, 000
<br />OTHER
<br />S
<br />S
<br />E
<br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
<br />RE: Combined Project Study Report /Project Report (PSR /PR), Environmental Document, (ED), and PS &E preparation for the
<br />SR -55 /MacArthur Blvd. Interchange Ramp Widening Project, Project Number 07 -2503
<br />The City of Santa Ana, its officers, agents, representatives, volunteers and employees are Additional Insureds on the
<br />General Liability including Completed Operations. Severability of Interest is included on the General Liability.
<br />See attached for additional wording.
<br />\,cm 1 Irl\,f► I r- nULUCYf I I ADDITIONAL INSURED; INSURER LETTER: UANUr -LLA I IUN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL IL3FMLXW@W MAIL 90 DAYS WRITTEN
<br />Public Works Agency M-36 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />USA
<br />AUUKU za -b (nai) rt- .Latowlcz o ACORD CORPORATION 1988
<br />6827336
<br />
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