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AL CIKU <br />Lam CERTIFICATE OF LIABILITY INSURANCE 9/30/2011 1 <br />DATE (M WDDNYYY) <br />9,22/2010 <br />PRODUCER Lockton Companies, LLC -i Kansas City <br />444 W. 47th Street, Suite 900 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Kansas City 00 64112 -1906 <br />(616)960 -9000 <br />ALLTER THE COVERAGE AFFORDED BYOTH THE BELOW <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED POST, BUCKLEY, SCHUH AND JERNIGAN, INC. <br />NSURERA Lloyd's of London <br />1307320 DBA PBS &J <br />2001 NW 107 AVENUE <br />INSURERS <br />INSURER C <br />MIAMI FL 33172 -2507 <br />INSURER D <br />INSURER E <br />COVERAGES PD THIS <br />CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING PROD CE TIV <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 />ADD1. <br />INSRD <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE (M MID D/Y'/) <br />POLICY EXPIRATION <br />I DATE (MMID <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ XXXXXXX <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE 1:1 OCCUR <br />NOT APPLICABLE <br />DAMAGE TO RENTED <br />PREMISES n <br />$ XXXXXXX <br />MED EXP (Any one person) <br />$ XXXXXXX <br />PERSONAL &ADV INJURY <br />$ XXXXXXX <br />GENERAL AGGREGATE <br />$ XXXXXXX <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMPIOP AGG <br />$ XXXXXXX <br />PRO - <br />POLICY JECT LOC <br />AUTOMOBILE <br />LLAB1UTY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ XXXXXXX <br />BODILY INJURY <br />(Per person) <br />$ XXXXXXX <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />NOT APPLICABLE <br />BODILY INJURY <br />(Per amident) <br />$ XXXXXXX <br />HIRED AUTOS <br />NON- OWNEDAUTOS <br />OPERTY DAMAGE <br />ere dent) <br />$ XXXXXXX <br />�^ <br />GARAGE LIABILITY <br />ANY AUTO <br />NOT APPLICABLE <br />rP <br />y G <br />pR� <br />AUTO ONLY - EA ACCIDENT <br />$ XXXXXXX <br />O THAN EA ACC <br />$ XXXXXXX <br />A <br />UTO ONLY. AGG <br />$ XXXXXXX <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR CLAIMS MADE <br />UMBRELLA <br />NOT APPLICABLE <br />La�Ta <br />Ass�stan <br />LOLL Shee TTIey <br />C,LY ALLO <br />EACH OCCURRENCE <br />$ xxxxxXX <br />AGGREGATE <br />$ XXXXXXX <br />$ XXXXXXX <br />DEDUCTIBLE FORM <br />$ XXXXXXX <br />$ XXXXxxx <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />W STATU- OTH- <br />TORY LIMITS ER <br />E L EACH ACCIDENT <br />$ XXXXXXX <br />AW PRDPRIErowPARTNEIIIII <br />OFFICERNEMBER EXCLUDED? <br />NOT APPLICABLE <br />E L. DISEASE - EA EMPLOYEE <br />$ XXXXXXX <br />(Mandatory in NH) <br />tt yes. ndato <br />e ems, <br />E.L. DISEASE - POLICY LIMIT <br />1 $ XXXXXXX <br />SPECIAL PROVISIONS xIO,. <br />A <br />OTHER <br />PROFESSIONAL,POLLUTION <br />LIABILITY <br />LDUSA1000811 <br />CLAIMS -MADE FORM <br />9/30/2010 <br />9/30/2011 <br />S1,000,000 EACH CLAIM & $1,000,000 <br />ANNUAL AGGREGATE, <br />11/11/1961 RETRODATE. <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHI CLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />RE: COMBINED PROJECT STUDY REPORT /PROJECT REPORT (PSR/PR), ENVIRONMENTAL DOCUMENT (ED), AND PS &E PREPARATION FOR TIIE <br />SR- 551MCARTHUR BLVD.; INTERCHANGE RAMP WIDENBVG PRROJECTT PROJECT NO. 07 -2503 <br />CITY OF SANTA ANA <br />PUBLIC WORKS AGENCY <br />20 CIVIC CENTER PLAZA, 4TH FLOOR <br />SANTA ANA CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />ACORD 25 (2009/01) 1 ®1988 2009 D CORPORATION. All rights reserved <br />The ACORD name and logo are registered marks of ACORD <br />Far awMIsna wgammg this cenMcaw, comae tlw number BsIdd In th• 1--r Ml m'bow. <br />