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._-, <br />AeORO" CERTIFICATE OF LIABILITY INSURANCE Cedinrale Number: 63 <br />PRODUCER <br />THIS CERTFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS <br />Marsh Cinidi LITItBd <br />VPON THE CERTIFICATE HOLDER. THIS CERTFICATE DOES NOT AMEND, EXTEND OR ALTER <br />Suite 1100, 222 — 3rd Avenue SW <br />THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Calgary, AB T2P 064 <br />INSURERS AFFORDING COVERAGE <br />NAIC • <br />INSURED <br />COMPANY A Federal Insurance Company <br />20281 <br />Telvsnt USA Corporation <br />1390 Piccard Drive. Suite 200 <br />COMPANY B L.ibeny Mutual Insurance C'ompa ny <br />23043 <br />CONPANYC AXis Reinsurance Company <br />20370 <br />Rockville, MD 20850 <br />COMPANY D <br />coNPAFIr E <br />COVERAGES <br />CO. <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY <br />EFFECTNE <br />DATE <br />NMIDO/YY <br />POLICY <br />E %PIRATK)N DATE <br />(MWOD/YY) <br />LIWTS <br />A <br />GENERAL LIABILITY <br />COYMERGAL GENERAL LIABILRY <br />GENERwL AGGREGATE <br />§2.000.000 <br />Q CLAIMS MADE ® OCCUR. <br />PRODUCTS- COMPJOP AGO <br />$2.000,000 <br />PRODUCTS L COMPLETED OPERATIONS <br />PERSONAL L ADV INJURY <br />E2.000.ODO <br />BVDDEN L ACCIpENT/LL POLLUTION <br />YOpLY INJURY AND PROPERTY DIIYAOE <br />3 SK7l)772 <br />U(1 /O 1 / 1 1 <br />n(s. n 1 / 12 <br />BLYIKET CONTRLCTUAL LIABILITY <br />EACH OCCURRENCE <br />$2,000.000 <br />FIRE DAMAGE (Any q.a lwa] <br />CROSS LIABILrtY <br />EMPLOYERS LIABILITY <br />MED EXP (qny p.a Darem) <br />$1 0.000 <br />9EVERABIUTY OF INTEREST <br />B <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />COMBINED SINGLE UNIT <br />$1,000.000 <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />A S I -67 7 -1 70470 -04 1 <br />06/01 / 1 1 <br />0610 U 1 2 <br />BODILY INJURY (Per Paraon) <br />BODILY WJURV (Pw Accitlenq <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />GARAGE LIABILRY <br />AUTO ONLY - EA AGGIpENT <br />ANY AUTO <br />OTHER TFIAN AUTO ONLY: <br />EACH ACCIDENT <br />AGGREGATE <br />C <br />EXCESS LIABILITY <br />UMBRELLA FORM <br />CT X/75288510 V 201 1 <br />06 /U 1 / I I <br />O6 /U 1: 1 2 <br />EACH OCCURRENCE <br />§3,000,000 <br />AGGREGATE <br />OTHER THAN UMBRELLA FORM <br />B <br />WORKERS' COMPENSATION AND <br />EMPLOYERS' LIABILTI <br />X <br />we 3TATV TORY <br />LiMrts <br />oTHER <br />EL EACH ACCDENT <br />§1,000.000 <br />THE PROPRIETOw IPARrNER3l ® INCL <br />WC2 -B71- 171)470 -051 <br />06.'(11 /11 <br />/)6 /01/12 <br />EL DISEASE - POLICY LIMIT <br />E1 DOO,000 <br />El[ECVTNE OFFICERS ARE: <br />Q EXCL <br />FL p16EA6F EACH EMPLOYEE <br />E 1 p00,000 <br />A <br />PROFESSIONAL LIABILITY /ERRORS 6 <br />OWSSIONS UABILJTY <br />35870772 <br />06/UI!11 <br />O(!OI /12 <br />EACH CLAIM. EACH W RONGFUL ACT <br />ANNUAL AGGREGATE <br />Eq,000,000 <br />$q 000000 <br />DESCRIPTON OF OPERATIONS I LOCATK)NS /VEHICLES /SPECIAL tTEM6 <br />RE: PROOF OFINSURANCE COVERAGE <br />It is hereby understood and agreed that the Ciry of Santa Ana, PWA — Transponalion 8 TraTFC Engineering Department, is added es en Additional Insured. with respect to the <br />above -noted general liability coverages, but only as [hair interest may appear with respect to [ha operations of [ha Named Insured described above. <br />Insurance is Primary and Non - Contributory. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />City of Santa Ana <br />sHwLD nwY or nrE PoLlo^s oescRleeD .lewely LE cnncru EO aFVO WrHe <br />rlienrnF. rHe .NSVRERIS. rFOPnwe cweance waI- Er,Dr.LyoR , IL <br />exvlwnriwR O.re <br />�q_ onus rrrrN <br />PWA - TTanspDTtaliLJn 8c Traffic Engineering <br />20 Civic Center Plaza <br />once ro Tr.e cERTIr ICnrE igLDER NnNeo .re REW. Sur FnlwSe ro unR sue.+ .+once s.,nlr <br />I"'E°a .`.o`e°n: col aEl °a se :`.n.:;rvFS on mE s�D uPC»+rHE �ESCU�E�w^sE,LrFOROINI; ruvEknoe. <br />uLS Or r,n s <br />AUTHORIZED REPRESENTATNE <br />Santa Ana, CA 92701 <br />/ <br />_I`.`, ,f <br />`y�`. _I <br />Attn: Vinh Nguyen, P.E., Sr. Civil Engineer <br />N.y w, 2o1T <br />—� Laura Sti�5rieedy <br />Assistant Oily Altor nc }� <br />ACORD 25 (2007/08) ®ACORD CORPORATION 1986 <br />• The Automobile - A51 -B7 1- 1 704 70 -040 and the Workcry Compensation - WC2 -B7 1- 1 704 70 -0 50 placcmenl was made by Marsh USA Inc. Marsh Canada Limited has <br />only acted in the role of a conadtans 10 the client with respect to Ihis placcmenl which is indicated above for your convenience. <br />