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�"� <br />ACORO` CERTIFICATE OF LIABILITY INSURANCE Cedificate NUmbeD 63 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS <br />Marsh Canada Limited <br />UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE GOES NOT AMEND, E %TEND OR ALTER <br />Suite 1'100, 222 — 3rd Avenue SW <br />THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />Calgary, AB T2P 0B4 <br />INSURED <br />COMPANY A Federul Insurance Company <br />20281 <br />Tlelvlent USA Corporation <br />1390 Piccard Drive, Suite 200 <br />COMPANY B Liberty Mutual Insurance Company <br />23043 <br />CoMPANYC Axis Keinsurance 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 />EFFECTIVE <br />DATE <br />MM /DD /YY <br />pOLICY <br />EXPIRATION DATE <br />(MM /DD /YY) <br />LIMITS <br />A <br />GENERAL LIABILITY <br />GENERAL AGGREGATE <br />$2,000,000 <br />COMMERCIAL GENERAL LIABILITY <br />PRODUCTS- COMP /OP AGG <br />$2.000.000 <br />Q CLAIMS MADE ® OCCUR. <br />PRODVCT9 6 COMPLETED OPERATIONS <br />PERSONAL B ADV INJURY <br />$2 000 OOO <br />SUDDEN 6 ACCIDENTAL POLLVTION <br />BODILY INJURY AND PROPERTY DAMAGE <br />35870772 <br />O6 /OI /11 <br />06/01/12 <br />EACH OCCURRENCE <br />$2.000 <br />000 <br />BLANKET CONTRACTUAL LIABILITY <br />FIRE DAMAGE (Any one fire) <br />CROSS LIABILITY <br />EMPLOYERS LIABILITY <br />9EVERABILITY OF INTEREST <br />MED EXP (Any one parson) <br />$t 0,000 <br />B <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMrt <br />$[.000,000 <br />BooILY INJURY (Per Person) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />AS) -B71- 170470 -041 <br />06/01/11 <br />06/01/12 <br />HIRED AUTOS <br />BODILY INJURY (Par Acotlenq <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />GARAGE LIABILITY <br />AUTO ONLY — EA ACCIDENT <br />ANY AUTO <br />OTHER THAN AUTO ONLY: <br />EACH ACCIDENT <br />AGGREGATE <br />C <br />E %C ESS LIABILITY <br />EACH OCCURRENCE <br />$3.000p00 <br />UMBRELLA FORM <br />C'fX /752885/0 I /201 I <br />06/0 I/ I 1 <br />06/01 / 1 2 <br />AGGREGATE <br />OTHER THAN UMBRELLA FORM <br />B <br />WORKERS' COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />X <br />we STATUronY <br />uMITS <br />OTHER <br />EL EACH ACCIDENT <br />$[,000,000 <br />THE PROPRIETOR /PARTNERS / ® INCL <br />EIrECUTIVE OFFICERS ARE: O EXCL <br />WC2 -B7 1- 1 70470 -05 1 <br />O6 /O1 /11 <br />06/01/12 <br />EL DISEASE - POLICY LIMIT <br />$1,000.000 <br />EL DISEASE EACH EMPLOYEE <br />$t A00,000 <br />A <br />PROFESSIONAL LIABILITY /ERRORS 6 <br />OMISSIONS LIABILITY <br />35870772 <br />06/0 I /1 I <br />06/0 I / 12 <br />EACH CLAIM. EACH WRONGFUL ACT <br />gNNUAL AGGREGATE <br />$4,000,000 <br />$4.000.000 <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /SPECIAL ITEMS <br />RE: PROOF OF INSURANCE COVERAGE <br />It is hereby understood antl agreed that the City of Santa Ana, PWA - Transportation 8 Traffic Engineering Department, is added as an Additional Insured, with respect to the <br />a bova -noted general liability coverages, but only as [hair interest may appear with respect to the operations of the Named Insured described above. <br />Insurance is Primary and Non - Contributory. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANV OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE <br />F_XPIRATIUN DTTE <br />C)t of Santa An$ <br />y <br />THEREOF, THE INS VRER(5) MFFOROING COVERAGE WILL ENDEAVOR TO MAIL BIZ DAYS WRITTF_N <br />ICE TO THE CERTIFICNTE HOLDER NAMED HEREIN. BVT F URE TO MAIL SUCH NOTICE SHP.LL <br />IINSURER(51 <br />PWA -- Trans ortation 8L Traf£c En inccrino <br />P P O <br />MPOSE NO OBLIGATION OR LIABILITY OF ANV KINU VPON THE AFFORDING <br />THEIR AGENTS OR REPRESENTATIVES O THE ISSUER OF THIS CERTIFICPTE. <br />C.OVERhGE. <br />AUTHORIZED REPRESENTATIVE <br />20 CIVIC Center Plaza <br />Santa Ana, CA 92701 <br />?i.' I � -���4. <br />A[tn: Vinh Nguyen, P.E., Sr. Civil Engineer <br />��F: May 30, 2011 <br />�_� r �2 <br />__�_�-- E� -_��' I_-- ---.___.. <br />r Laura. SISL�Shcedy <br />Assistant l�S ty Att orne�; <br />ACORD 25 (200'1/08) ©ACORD CORPORATION '1988 <br />* 'The Automobile - ASI -f3 7 1- 1 70470 -040 and the Workers' Compensation WC2 -137 1- 1 70470 -05 0 placement was made by Marsh LJSA Inc. Marsh Canada Li roiled has <br />only acted in the role of a consultant to the client with respect to this placement which is indicated above for Your convenience. <br />