|
<br />Client#: 1260332 305ECOIN'0GRO
<br />Y,
<br />?lCORD-. CERTIFICATE OF LIABILITY INSURANCE D04/271 22012
<br />04127
<br />x12
<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 She certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s).
<br />PRODUCER CONTACT
<br />NAME: _
<br />BBSrT Insurance Services ?HONE 714 578.7000 FAX
<br />I?AfC, No, Ext): _ AIC, No):
<br />of Orange County E-MAIL
<br />680 Langsdorf Drive Suite 100 ADDRESS
<br />INSURER(S) AFFORDING COVERAGE NAIC
<br />Fulleriurr, Cs- 2831 ,NSrJRERAJmvel ara Prupei¢y (.:tsualty Co 25674
<br />INSURED
<br />Aegis ITS, Irc.
<br />33601 E. La Palma Ave.
<br />Anaheim, CA 92806
<br />INSURER B : Liberty Insurance Undtarwriters
<br />INSURER C : RSUI Indemnity Company
<br />COVERAGES C_FRTIFICATF NIIMRFR- PP1'A4 rU'J Ali llURFR•
<br />THIS IS TO C:".KTiFY THAT THE PO!_ICIES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE rtP Y BE !SSI,ED 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 SEEN REDUCED BY PAID CLAIMS.
<br />1NS
<br />LTRR OF INSURANCE ADDLSUB _
<br />INSR WVD POLICY NUMBER
<br />r POLICY EFF POLICY EX LIMITS
<br />'• MMIDDIYYYY MMIDDiY'YYY?i
<br />
<br />A
<br />GENERALLLASILfTY
<br />6303193N600TIL12 ,T^
<br />4/2712012 04!27/201jEACH OCCURRENCE
<br />$1000000
<br />?
<br /> COMMERCIAL :GENERAL L!ABILiTY
<br />I_?
<br />-- PrtnRAGE TC
<br />, EMIISES rEa .RENTED. ce
<br />'----._
<br />s 300,000
<br /> !.......--.I CI?"-S-Y. 4!F A] OCCUR I "
<br />MED EXP (k,ny one person) $5,000
<br /> 1 PEKf30 NAL & ADV INJURY $1,000,000
<br /> I GENE11 L AGGREGATE #2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER:
<br />- - PRODUCTS -COMP/OP AGG $2,000,000
<br />
<br />
<br />A i
<br />PRO- I
<br />HOC
<br />BILITY
<br />
<br />
<br />103193N600TIL12
<br />
<br />
<br />412712012
<br />
<br />
<br />4127/201 ; Ot.b"" S" LE LIMIT
<br />
<br />
<br />1,000,000
<br /> X! ANY AUTO)
<br />r...? f BODILY INJURY (Per person) $
<br /> ALL OWNIEC, SCHEDULED
<br />AUTOS AUTOS
<br />X; NON-OWNED
<br />HIREDAUiLIS X AUTOS
<br />_--? I
<br />
<br />
<br />I I
<br />
<br />I
<br />kIODILY:NJURY (Per accident)
<br />PROPERTY DAMAGE
<br />
<br />-1Per accident
<br />$
<br />
<br />$
<br />i
<br />
<br />B I l
<br />
<br />X? uM3RcL_A IAB X OCCUR
<br />
<br />I
<br />
<br />UMBLA2559181
<br />
<br />:04/2712012
<br />
<br />tr;127 /2013. E AC H OC-GURRENCE
<br />$
<br />s2,000,000
<br /> EXCESS LIAB
<br />CLAIMS-MADE
<br />T--. s2000000
<br /> DED RETENTION $ ! $
<br />WORKERSCOAVENSATION
<br />AND U B9501 809612
<br />AND EMPLOYERS' LIABILITY Y 1 N
<br />ANY PROF RIE'OldPARTNERJEXE0UTIV£
<br />
<br />OFFICERJMEMBER EXC-UDED? ? N I A
<br />(Ma;?datpry in ?"N'', CNCST.A7U- H-
<br />!0412712012 04/271201 Z X _
<br />__._114 >' IT R _
<br />E.L.. $1
<br />EACH ACCIDENT ,000000
<br />--
<br />
<br />I 'I E.L. DISEASE - EA EMPLOYEE $1
<br />000
<br />000
<br />If yes, oescriha u„der
<br />DES AWTtON OF OPERATIONS below ,
<br />,
<br />! E-L D!SGiSE-POLICY DMIT $1,000,000
<br />
<br />C Auto Excess NHA230367 _? . ----
<br />;0412712012 04/271201 j;1,00+3,000
<br />Liability
<br />1 , ? a
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedab=, if more space is required)
<br />Certificate Holder is added as Additional Insured per policy form #CGD2,1170805 & Waiver of Subrogation
<br />per policy forin #CGD4581008 both a part of policy #-6303193N600TIL12 .
<br />Certificate Holder is amended to read: The City, its officers, employees
<br />volunteers and representatives , agents,
<br />RE: Traffic Sic?rai ;System, Advanced Traffic Management System, and Straet Light System Maintenance in and
<br />xa
<br />for the of "
<br />City (3'e ?d'oita Ana. 1 t '
<br />City of Santa Ana
<br />Attr'I: Vinh Nguyen
<br />P.F:. Box 1988 / M043
<br />Sari'.? Ana, CA 92702-1988
<br />IION
<br />I SHOULD ANY OF THE ABOVE DESC tfSE )?OiJCIES BE CANCELLED BEFORE
<br />- 4---Q-IE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />1 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />' ??I! 771.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 2= 120?,Iii)5) 1 of 1
<br />#S 8543 8 ? i311V1 a 543853
<br />©1988-2010 ACORID CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />CLRAG
|