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ACdRO' CERTIFICATE OF LIABILITY INSURANCE Cedificete Number: 63 <br />PRODUCER <br />THIS CERTFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS <br />Marsh Canada LImN®d <br />VPON THE CERTFICATE HOLDER. THIS CERTFICATE DOES NOT AMEND. E %TEND OR ALTER <br />Suite � 700, 222 — 3rd Avenue $W <br />THE COVERApE AFFORDED BY THE POLICIES BELOW. <br />Calgary, AB T2P 064 <br />INSURERS AFFORDING COVERAGE <br />NAIC +� <br />INSURED <br />CONPANYA Federal InsUranCf CUmpa ny <br />20281 <br />Talvgnt USA Corporation <br />1390 Piccard Drive. Suite 200 <br />COMPANY B Liberty Mutual Insurance Company <br />23043 <br />eoMPANYC Axis Reinsurance Company <br />20370 <br />Rockville, MD 20850 <br />COMPANY D <br />COMPANY E <br />COVERAGES <br />CO. <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY <br />EFFECTNE <br />POLICY <br />E %PIRATION DATE <br />LIMITS <br />GATE <br />MM/DD/YY <br />(MM/DOMY) <br />A <br />GENERAL LIABILITY <br />COYMERtlAL GENERAL LIA61LlrY <br />GENERAL AGGREGATE <br />$2.000,000 <br />Q CLAIMS MADE ® OCCUR. <br />PRODUCTS- COMP /OP AGG <br />$2,000.000 <br />PROOYCTS L COMPLETED OPERATIONS <br />PERSONAL 6 ADV INJURY <br />$2,000.000 <br />SYDOEN 8 ACCIDENTAL POLLUTION <br />YoaLY INJURY Ar.D PROPERTY DANAOE <br />3$870772 <br />OCT /OI /II <br />OGiOI /I2 <br />EACH OCCURRENCE <br />$2AfX).000 <br />BLANKET CONTRACTUAL LIABILRY <br />FIRE DAMAGE An <br />l Y wln fire) <br />CROSS LIAaILrtY <br />EMPLOYERS LIABILITY <br />ME D EXP (Any dle par3Dn) <br />$1 0.000 <br />SEVERAB0.nY OF INTEREST <br />B <br />AUTOMOBILE LIABILRY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />$1,000.000 <br />ALL OWNED AUTOS <br />BODILY INJURY (Pe PSraon) <br />SCHEDULED AUTOS <br />ASI -B71- 170470 -041 <br />06/01/11 <br />U6 /OI 112 <br />BODILY INJURY (Par AcciGanl) <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />GIIRAOE LIABILrTY <br />AUTO ONLY - EA ACCIDENT <br />ANY AUTO <br />OTHER TFIAN AUTO ONLY: <br />EACH ACCIDENT <br />AGGREGATE <br />C <br />E %LESS LIABILITY <br />uMBRELLP. FORM <br />C 1'X/752885/0 1; 201 1 <br />O6 /O I/ I 1 <br />06/0 1: 1 2 <br />EACH OCCURRENCE <br />$3,000,000 <br />AGGREGATE <br />OTHER THAN UMBRELLA FORM <br />B <br />WORKERS' COMPENSATION AND <br />X <br />we srATUTOgY <br />EMPLOYERS' LIABILfTY <br />LIMITS <br />OTHER <br />THE PROPg1ETOR /PARTNFRB/ ® INCL <br />WC2- 671 - 170470 -051 <br />06.'01/1 I <br />U6/OI/12 <br />EL EACH ACCIDENT <br />$1,000,000 <br />EL DISEASE - POLICY LIMIT <br />$1.000,000 <br />EIECUTIVE OFFICERS ARE: O EXCL <br />FL OISF_ASF EACH EMPLOOYRF <br />$1,000,000 <br />A <br />PROFESSIONAL LIABILITY /ERRORS 6 <br />EACH CLAIM. EACH WRONGFUL ACT <br />$4.000,000 <br />OMISSIONS LIABILITY <br />35K70772 <br />06/0 1!11 <br />06/01/12 <br />ANNUAL AGGREGATE <br />$4,Opp,p00 <br />DE6CRIPTON OF OPERATIONS /LOCATIONS /VEHICLES /SPECIAL rTEMS <br />RE PROOF OF INSURANCE COVERAGE <br />It is hereby urWerstootl and agreed [hat the City of Santa Ana, PWA - Transportation & Traffic Engin¢aring Department, is adtled as an Additional Insured. with respect to the <br />above -noted general liability coverages, but only as [hair interest may appear with respect to the operations of the Named Insured described above. <br />Insurance is Primary end Non - Contributory. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />City of Santa Ana <br />SHIXJLD wNV Ci THEgpOLIC,IE `DESCgIBEO HEREIN 9E CANCELLEV BEFpR: lHE <br />THERFOr. THE INS (51 w ONpINO f.OVERK:E WILL ENDwEAVOR TO IL <br />EYnIRaTION OS {E <br />�D- DtY3 WRI rTEN <br />PWA -- TranSrLlrlallOn 8c Trafl iC En inccrin <br />NOTCE TO THE CERTIFICATE fIOLDER NAMED HEREIV, BVT F (LURE TO MML <br />IMPOSE NO OBLIGTION OR LMBILITY OF MlV AND Ur\'JN THE INSVRERI51 AFFri2DINC <br />TI£IR AGENT'./Oq REpRE3ENTATIVE50R 159VER OF THIS CEgTKICMTE. <br />wE <br />SVCH NOTICE SHILLL <br />GWEgAGE. <br />_ ST ST <br />20 C rvtc Center Plaza <br />AUTHORIZED REPRESENTATNE <br />i _� <br />Santa Ana. CA 92701 <br />._`. `- \�`�, <br />Aun: Vinh Nguyen, P.E., Sr. Civil Engineer <br />May so, 2Dt1 <br />/ !2. <br />i Laura Slit,[ Shcc.dy <br />Ass'i�fant Oily Altor nc�� <br />ACORD 25 (200TM8) 0 ACORD CORPORATION 1988 <br />The Automobile - ASI- 6 7 1 - 1 704 70 -040 and the Workers' Compensation - WC'2 -671- 170470 -050 placement was made by Marsh IJSA Inc. Marsh Canada I_i mired has <br />on1Y acted in the role of a consu ltanl to the client with respect to this placement which is indicated above fiTr your com�enicnee. <br />