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<br />*ACORDTM CERTIFICATE OF INSURANCE G¢rtllicalB NDmbDr 3 <br /> <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS <br /> UPON THE CERTIFICATE HOLDER. TNIS CERTIFICATE DOES NOT AMEND, IXTEND OR ALTER <br />Marsh Canada limited THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />SW <br />d A <br />222 <br />3 <br />r <br />venue <br />- <br />Suite 1100, COMPANIES AFFORDING COVERAGE <br />CDlgary, AB T2P 0B4 <br />INSURED COMPANY A Federnl Insurance Company <br />TBIVent FarradYDB 100. COMPANY B American Home Assurance Company <br />3206 Tower Oaks Blvd. <br /> COMPANYC Libert}'Mu[ual insurance Company <br />MD 20852 <br />Rockville <br />, COMPANY D Chubb Insurance Company of Canada <br /> COMPANY E <br />COV ERAGES <br /> <br />CO POLICY POLICY <br />. <br />LTR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE GATE IXPIRATION DATE LIMITS <br /> MMIDDM/ MMIDD <br />A GENERAL AGGREGATE $ 2,000,000 <br /> GENERAL LIABILITY <br /> PRODUCTS-COMPIOP AGG $ 2,000,000 <br /> COMMERCIAL GENERAL LIABILRY <br /> ^ LLAIM$MADE ® OCCUR. PERSONALSADV INJURY S 2,000,000 <br /> PRDDUCT38 COMPLETED OPERATIONS EACH OCCURRENCE S P,000,000 <br /> ® SUDDENB ACCMENTAL POLLUTN)N 35870772 06'01!08 06/01/09 <br /> ® BODILY INJURY ANO PROPERTY DAMAGE FIRE DAMAGE (Apy On¢Lr¢) $ <br /> <br /> BLANKET CONTMCTUAL LIABILrrY <br /> CROSS LMBILITY MED EXP (Anyore person) $ 10400 <br /> EMPLOYERS LMBILm' <br /> SEYERABILITY CF INTEREST <br />A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000.000 <br /> ANV AUTO <br /> ^ ALL OWNED AUTOS <br />/ BODILY INJURY fPer Person! 8 <br /> ^ 73546717 O6lU 1/08 06/01 <br />09 <br /> SCHEDULED AUro$ BODILY INJURY (Per ACCioenO $ <br /> ^ HIRED AUTOS <br /> ^ NON-OWNED AUTOS PROPERTY DAMAGE $ <br /> GARAGE LIABILfTY AUTO ONLY-EA ACCIDENT 5 <br /> ^ ANV AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT S <br /> AGGREGATE $ <br />B E%CE33 LIABILITY EACH OCCURRENCE $ 3.000,000 <br /> / <br />9 <br /> UMBRELLA FORM BE 6849135 06/01/06 06!01 <br />0 $ <br /> OTHER THAN UMBRELLA FORM AGGREGATE $ <br /> WORKERS' COMPENSATION AND WC STarmORV OmER <br />X <br />C EMPLOYERS' LIABILITY LIMITS <br /> <br /> EL EACH ACCIDENT 3 t,ooG,DaD <br /> <br /> ® WC2-B71-17047U-92$ 1)2/16/1)8 92/16!09 <br /> INCL <br />THE PRDPRIETORIPARTNERSI EL DISEASE-POLICY LIMIT $ 1,000,000 <br /> E%ECOTIVE OFFICERS ARE: ^ <br /> E%LL <br /> EL DISEASE EACH EMPLOYEE $ t,ooD,oao <br />D PROFESSIONAL LIABILITYI ERRORSB <br /> OMISSIONS LIABILITY EACH CLAIM, EACH WRONGFUL ACT $ 5,000,000 <br /> 35789699 06!01/08 06/01/09 <br /> ANNUAL AGGREGATE $ 5,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATION31 VEHICLES I SPECIAL REMS <br />RE PROOF OF INSURANCE COVERAGE <br />It is hereby untlerstood and agreed that the City of Santa Ana, PWA-Transportation & Traffc Engineedn9 Depadment, is adtletl as an Additional Insured, with respect to the <br />above-notetl general liability coverages, but only as their interest may appear with respell to the operations of the Named Insuretl described above. <br />Insurance is Primary and Nan-Contributory. <br />CERTIFICATE HOLDER CANCELLATION <br /> SHWLD NNY OF iNE PCLICIE$ DESCRIBED HEREIN RE GNLELL ED BEFORE iXE E%PIPATIdJ DATE <br /> <br /> <br />~ ,,if1EREOF. THE INSDREPIS) PF FORDING GWEMOE WILL ENDEAVOR iO IMIL ?i DAYS WRITTEN <br />BDT FAILVRE TO MAIL SUCH NOTICE STALL <br />fAJTILE TO THE CERTIFICATE BOLDER N\M1EO HEREIN <br />t` <br />Santa Ana <br />Clty D Y ` ~ <br />Y . <br />IMPOSE NO OBLIOATION'JR LIABILItt Cf ANV KIND UPoN THE INSVRERIS) PFFOgDING LOVEMOE. <br />I <br />~ TIEIR FOENTS OR REFRESENTATIVES, ORTIE ISSVER OF iH15 CERTIFICATE <br />P~VA Transportation & Traffic Engineering MARSH CANADA uMRED <br />20 Civic Center Plaza N ` <br />~ ~ r ~`~1`' <br />t <br />Santa Ana. CA 92701 ~,. - ~ <br />'- <br />-~ <br /> iD <br />MMT (m3z) - n OF: i3JU403 <br />Attn: Vinh Nguyen, P.E., Sr Civil Engineer <br />