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A CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY) <br />1/13/203/2011 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER CONT Commercial Lines - (949) 225-6900 NAMEACT Maegan Kawczynski <br />PHONE -225-6914 <br />/NoL949-225-6910Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408(A/C.No E.11: <br />E-MAIL <br />2030 Main Street, Suite 200 ADDRESS: maegan.kawczynski@wellsfargo.co <br />PRODUCER <br />Irvine, CA 92614-7253 ----- -- <br />CUSTOMER ID #: PACIF20 <br />INSURED - -- ---- <br />Pacific Advanced Civil Engineering, Inc. <br />v wv _"M _ <br />INSURERA: Seabright Insurance Company <br />-_ _NAT <br />15563 <br />INSURER 8: <br />17520 Newhope Street <br />-- <br />INSURER C: <br />- -- -- <br />INSURER D: <br />Fountain Valley, CA 92708 <br />INSURER E: <br />PERSONAL & ADV INJURY $ <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 2269032 REVISION NUMBER: See below <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 />NSR ADDL SUBR - <br />LTR TYPE OF INSURANCE POLICY NUMBER MM DPOLIDYY/EYYY MMIDPOLICYEXP <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />_ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED - <br />—� PREMISES Ea occuvenceL__ <br />CLAIMS -MADE LOCCUR <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />Evidence of Workers' Compensation Liability coverage for the Named Insured. <br />CERTIF <br />tire <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />@ 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />MED EXP (Any one person) _ $ <br />PERSONAL & ADV INJURY $ <br />— <br />GENERAL AGGREGATE $ <br />---- <br />-- <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO- <br />JECT LOC <br />,1 <br />PRODUCTS -COMP/OP AGG $ <br />— <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />'^.3 <br />COMBINED SINGLE LIMIT <br />(Ea accident) $ <br />ALL OWNED AUTOS <br />_ i <br />BODILY INJURY (Per person) $ <br />SCHEDULED AUTOS} <br />HIRED AUTOS <br />NON- OWNED AUT OS <br />y /y <br />.,7 <br />-. <br />BODILY INJURY (Per accident) , $ <br />AMAGE --�-- <br />PROPERTY D $ <br />(Per accident) <br />-- <br />- — <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />IM S MAD E <br />EACH OCCURRENCE $ <br />—_ I <br />— <br />AGGREGATE g <br />DEDUCTIBLE <br />� <br />— � - <br />— --- <br />RETENTION $$ <br />WORKERS COMPENSATION <br />$ <br />A <br />AND EMPLOYERS' LIABILITYWC <br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />N / A <br />6B1113671 <br />01/01/11 <br />01/01/12 <br />STATU- OTH- <br />X T RY LIRA ER <br />E.L. EACH ACCIDENT $ 1,000,000 <br />---- <br />E.L. DISEASE - EA EMPLOYE $ 11000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />— <br />E.L. DISEASE -POLICY LIMIT $ 1,000,000 <br />I <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />Evidence of Workers' Compensation Liability coverage for the Named Insured. <br />CERTIF <br />tire <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />@ 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />