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<br />AeC>Rh® CERTIFICATE OF LIABILITY INSURANCE
<br />kw�6/1/201&1.
<br />DATE (mm,DD
<br />3/5/2014
<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 ondorsement(s).
<br />PRODUCER Locktun Companies, LLC -I Kansas City
<br />444 W. 47th Street, Suite 900
<br />Kansas City MO 64112.1906
<br />(816)960-9000
<br />CONTACT
<br />NAMEi
<br />PHONENo FAX
<br />I:
<br />C ExtAC No s
<br />EMAIL
<br />ADOR S$,
<br />INSURERIS) AFFORDINO COVERAGE NAIL #
<br />GENERAL LIABILITY
<br />INSURER A: Hartford Fire Insurance CorapMy 19682
<br />Y
<br />INS"" i3DR ENGINEERING, INC.
<br />1013472 8404 INDIAN HILLS DRIVE
<br />INSURER B: St, Paul Fire and Marine Insurance Company
<br />INSURER c: Sentinel Insurance CEipany, Ltd. 11000
<br />OMAHA, NE 68114.4049
<br />INSURER o: Zurich American Insurance Coaany 16535
<br />INSURER E
<br />X MMERCIAL GENE LLI BILIN
<br />INSURER F:
<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 WfPH 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 />ADDL
<br />INSR
<br />SUBR
<br />VIVO
<br />''-'
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYW
<br />POLICY EXP
<br />MM)OOIYYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />Y
<br />Y
<br />37CSEQUO950
<br />6/1/2013
<br />6/1/2014
<br />_
<br />EACH OCCURRENCE t1,000.000
<br />DAMAGETO RENTED
<br />PREMISES (Ea accunanca) $ 10000000
<br />X MMERCIAL GENE LLI BILIN
<br />"ETEXPPAny.1.P.R.,D $ 10000
<br />CLAIMS�N,ADE OCCUR
<br />X Contractual Liab.
<br />PERSONAL& ADVINJURY s 1,000,000
<br />_
<br />GENERAL AGGREGATE $ 2,000.000
<br />G_EN'L AGGREGATELIMITAPPNES PER;
<br />PRODUCTS-COMNOP AGG $2000000
<br />C, X LOC
<br />POLICY X J,Or
<br />$
<br />A
<br />A
<br />A
<br />AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />N
<br />N
<br />37CSEQUO951 AOS)
<br />37CSHQQU0952 HT1
<br />37MCVQ,UI 16C INA)
<br />6/12013
<br />6/1/2013
<br />CUERO
<br />6/1/2014
<br />6/1/2014
<br />6/1/2014
<br />'"'
<br />(Ea acoiaerR $ 2000000
<br />BODILY INJURY (Par parson) $ XX IXx'
<br />ALLOWNEDAUTOSSCHEDLEO
<br />ALLOS AUTOS
<br />BODILY INJURY Psracddenl S XXXXXXX
<br />PROPERTY DAMAGE $ xXxxxxx
<br />X HIRED AUTOS 'Y AUTp54UNED
<br />$xxxxxxx
<br />B
<br />X UMBRELLA LIAR
<br />I g
<br />I OCCUR
<br />N
<br />N
<br />ZUP-IOR6408413-NF
<br />SM201'11
<br />6/1/2014
<br />EACH OCCURRENCE Is 111000.00
<br />EXCESS LIAR
<br />rl
<br />CLAIMS -MADE
<br />(EXCLUDES PROF, LIAB)
<br />AGGREGATE$ 1-D0 okoo
<br />DED X RETENTION$ $0
<br />...r_ _ a XXXXXXX
<br />xx
<br />G
<br />G
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIADILITYYIN
<br />ANY PROPRIETORIPARTNEREXEOUTIVE
<br />OFFICER/MEMI EXCWOED4 N
<br />(Mandatory In NH)
<br />H yes, describe under
<br />NIA
<br />Y
<br />91WBOIII 000 ((AOS)
<br />91WEOF11760 (Hl)
<br />7/1/2013
<br />7/1/2013
<br />7/1/2014
<br />7/12014
<br />5 - OT -
<br />X TORV LIMIT ER
<br />E.L. EACH ACCIDENT $ ]HPD HHH
<br />P.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />E.L. DISEASE POLICY LIMIT $ 1,000,000
<br />DISCRIPTION Of OPERATIONS b.l,,
<br />D
<br />ARCHS n, ENGS
<br />NN
<br />ECC9260026-06
<br />6/l/2013
<br />6/t/2014
<br />PER CLAIM: $1,000,000. AGG:
<br />PROFESSIONAL
<br />LIABILITY
<br />$1,0001000.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS)VEHICLES (Attach ACORD 101, AddRanal Remarks Schedule, smoro space is regnihd(
<br />RE; CITY OF SANTA ANA MASTER ON-CALL DATED FEBRUARY 4TH, 2014. THE CITY OF SANTA ANA, IT'S OFFICERS, EMPLOYEES, AGENTS,
<br />AND REPRESENTATIVE ARE NAMED AS AUDI VIONAL INSURED ON GENERAL LIABILITY AS PER WRITTEN CONTRACT, ON A PRIMARY,
<br />NON-CONTRIBUTORY BASIS, WAIVER OF SUBROGA'T'ION APPLIES WHERE ALLOWABLE BY LAW, SEVERABILITY OF INTERESTS APPLIES, 30
<br />DAYS NOTICE OF CANCELLATION APPLIES, 10 DAYS NOTICE FOR NONPAYMENT OF PREMIUML
<br />APPROVED AS O F011,.'
<br />Laura A. Rossini
<br />Assistant City Attorney
<br />12801990
<br />CITY OF SANTA ANA
<br />ATTENTION: PURCHASING DEPARTMENT
<br />20 CIVIC CENTER. PLAZA
<br />SANTA ANA CA 92702
<br />The ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />
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