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acORO® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DDnwY)
<br />10/10/2013
<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(les) 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
<br />Dealey, Renton & Associates
<br />P. O. Box 10550
<br />Santa Ana CA 92711-0550
<br />NAMONTAE: T Karin Thorp
<br />PHONE AIC No : 1
<br />E-MAIL
<br />ADUREss:
<br />INSURERS AFFORDING COVERAGE NAIC If
<br />Y
<br />IINSURERA:ACE Amer Cao lo2uraoQe QQmpany 2266Z
<br />630265M676A
<br />INSURED
<br />INSURER B:Travelers Property ) l Cc of A 25674
<br />INSURER C
<br />PSOMAS
<br />555 South Flower Street, Suite 4300
<br />Los Angeles CA 90071
<br />INSURER D:
<br />INSURER E
<br />INSURER F
<br />PREMISES Es occR111urrence $1,000,000
<br />COVERAGES CERTIFICATE NUMBER: 1227330943 REVISION NUMBER:
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADO
<br />INSR
<br />UBR
<br />MD
<br />POLICY NUMBER
<br />POLICYEFF
<br />MMIDDNYYY
<br />POLICY EXP
<br />MMIDOIYYYY
<br />LIMITS
<br />B
<br />GENERAL LIABILITY
<br />Y
<br />Y
<br />630265M676A
<br />10/15/2013
<br />0/15/2014
<br />EACH OCCURRENCE $1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />-1
<br />PREMISES Es occR111urrence $1,000,000
<br />CLAIMS -MADE IX OCCUR
<br />MED EXP Any one person $10,000
<br />PERSONAL &ADV INJURY $1,000,000
<br />X Contractual
<br />X BFPD,XCU
<br />GENERALAGGREGATE $2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGO $2,000,000
<br />$
<br />POLICY X PRO- LOC
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />BA6A708266
<br />10/15/2013
<br />0/15/2014
<br />Ea accident 1,000,000
<br />BODI LY INJURY (Per person) If
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident) $
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE $
<br />Per accident
<br />UMBRELLA LIAS
<br />OCCUR
<br />EACH OCCURRENCE $
<br />AGGREGATE $
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YINTS1
<br />y
<br />UBOA526643
<br />10/15/2013
<br />0/15/2014
<br />X WC STATU- OTH-
<br />UM
<br />E.L, EACH ACCIDENT $1,000,000
<br />ANY PROPRIETORIPARTNERIEXECUTIVE❑
<br />OFFICER/MEMBER EXCLUDED?
<br />NIA
<br />E.L. DISEASE LA EMPLOYEE $1,000,000
<br />(Mandatory In NH)
<br />Ifyee,describeunder
<br />DESCRIPTION OF OPERATIONS below
<br />E L. DISEASE. POLICY LIMIT $1,000,000
<br />A
<br />Professional Liability
<br />G23638381005
<br />10/15/2013
<br />0/15/2014
<br />Per Claim$1,000,000
<br />Claims Made
<br />Annual Aggregate $1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is req Intact)
<br />General Liability policy excludes claims arising out of the performance of professional services.
<br />Independent Contractors Included as respects to General Liability.
<br />30 Day Notice of Cancellation
<br />2SAN410110; Professional Engineering Design Services Bristol Street Water Main Replacement.
<br />City, its officers, employees, agents, volunteers and representatives are additional insured as respects to General and Auto Liability as
<br />required by written contract. Primary and Non -Contributing coverage, Waiver of Subrogation applies to GL as required by written contract.
<br />See Attached...
<br />CERTIFICATE HOLDER CANCELLATION 10 Dav notice for Non-Pavmnt of Prem
<br />ACORD 25 (2010/05)
<br />© 1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Rudy Rosas
<br />220 S. Daisy Ave., M-85
<br />Santa Ana CA 92703
<br />AU HORIZED REPRESENTATIVE
<br />C`~R.UN.., CJ r f moi. C1
<br />ACORD 25 (2010/05)
<br />© 1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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