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oA�BPM CERTIFICATE OF LIABILITY INSURANCE <br />09 /20 /z 0 ' <br />PRODUCER (305)822 -7800 FAX (305)362 -2443 <br />Collinsworth Alter Fowler Dowling & French Group <br />P. 0. Box 9315 <br />Miami Lakes, FL 33014 -9315 <br />Attn : Anna Ramirez, ext 120; aramirez@cafdf.com <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 POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED Post, Buckley, Schuh, & Jernigan, Inc. <br />d /b /a PBS &J <br />2001 NW 107 Avenue <br />Miami, FL 33172 -2507 <br />A— — <br />INSURER A. Lloyds of London A XV <br />POLICY EFFECTIVE <br />INSURER B: <br />LIMITS <br />INSURER C: <br />INSURER D: <br />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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LliviiTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />ADD'L <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED <br />$ <br />CLAIMS MADE ❑OCCUR <br />MED EXP (Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG <br />$ <br />POLICY PRO- <br />JECT LOG <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per person) <br />$ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />H ANY AUTO <br />OTHER THAN EA ACC <br />$ <br />$ <br />AUTO ONLY: AGG <br />EXCESS /UMBRELLA LIABILITY <br />EACH OCCURRENCE <br />$ <br />OCCUR FI CLAIMS MADE <br />AGGREGATE <br />$ <br />$ <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION AND <br />WC STATU- I OTH- <br />TORY LIMITS FR <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETORlPARTNERIEXECUTIVE <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />SPECIAL PROVISIONS below <br />Professional/ <br />LDUSA0700811 <br />09/30/2007 <br />09/30/2008 <br />$1,000,000 Limits <br />A <br />Pollution Liability <br />Ea Claim and Annual Aggregate <br />CLAIMS -MADE FORM <br />11/11/1961 Retrodate <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />E: Project No.: 07 -2503; Combined Project Study Report /Project Report (PSR /PR), <br />nvironmental Document, (ED), and PS &E preparation for the SR -55 /MacArthur Blvd. Interchange Ramp Widen <br />roject <br />Issuing company will provide 30 days written notice of cancellation; 10 days for non - payment. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Santa Ana, City of EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />Public Works Agency M -36 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />20 Civic Center Plaza BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />4th Floor OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br />...... <br />_ <br />Meade Collinsworth /ANNA <br />ACORD 25 (2001108) OACORD CORPORATION 1988 <br />