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<br />.RightFax N3-2 <br /> <br />1/28/2010 4:16:27 PM PAGE <br /> <br />2/003 <br /> <br />Fax Server <br /> <br />AUTOMATIC DATA PROC INS AGCY INC <br />71 HANOVER RD MS 625 <br />FLORHAM PARK, NJ 07932 <br />(877) 677-0428 <br />XV770 <br /> <br />4- () <br />CERTIFICATE OF LIABILITY INSURANCE ~~~~~~;~f~YYYY) <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> <br />AC08D,.: <br /> <br />I <br /> <br />PRODUCER <br /> <br />70A <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />NAIC# <br /> <br />INSURED <br />CONSENSUS, INC <br />626 WILSHIRE BLVD, #1000 <br />LOS ANGELES, CA 90017 <br /> <br />INSURER A:TRAVELERS CASUALTY AND SURETY COMPANY <br />INSURER B: <br />INSURER C: <br />INSURER D <br />INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, tHE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR ADD'l POLICY EFFECTIVE POUCY EXPIRATION <br />LTR INSR[ TYPE OF INSURANCE POUCY NUMBER DATE tMMlDDIYYI DATE IMM/DDlYYl UMITS <br /> GENERAL LIABIITY EACH OCCURRENCE $ <br /> - , <br /> CO~MERCIAL GENERAL LIABILITY DAMAGt 10 HtN I tU $ <br /> - tJ:CLAIMS MADE D OCCUR <br /> - MED EXP (Anv one nerson) $ <br /> I $ <br /> PERSONAL 8. ADV INJURY <br /> "'~"~D^' $ <br /> I ~~,.,~, ,,.,~~ . ~()MPK1P A~~ <br /> GEN'L AGGREGATE LIMIT APPLIES PER $ <br /> II nPRO- nl <br /> POL;ICY JECT LOC <br /> ~OM'BILE UABIUTY COMBINED SINGLE LIMIT <br /> (Ea accidenl) $ <br /> - AN~ AUTO <br /> AWOWNED AUTOS BODILY INJURY $ <br /> - (Per person) <br /> - SC~EDULED AUTOS p...S 1'0 fO ~M <br /> - HIRED AUTOS t\-PPRO\lBD BODILY INJURY <br /> (Per accidenl) $ <br /> - NON-OWNED AUTOS ~-:-- <br /> I -~jfgJ ~ rt..9~~~Jln~AMAGE $ <br /> GARAG~ LIABILITY r: .--?V St'tt :'U'-" ., $ <br /> ~r2 ", p.ltOrne AUTO ONLY - EA ACCIDENT <br /> ~ AN~ AUTO p..sststa t Ctt)' - OTHER THAN EA ACC $ <br /> AUTO ONLY AGG $ <br /> EXCEssYUMBRELLA LIABILITY EACH OCCURRENCE $ <br /> tJ OCCUR D CLAIMS MADE AGGREGATE $ <br /> I $ <br /> I <br /> R DEdUCTIBLE $ <br /> RETFNTION $ XI~ IU~~ $ <br />A WORKERS COMPENSATION AND UB-9081 C486-1 0 01/01/2010 01/01/2011 <br /> EMPLOYERS'L(ABILITY EL EACH ACCIDENT ~ 1 ,000 000 <br /> ~~lb~~R~iEW~~~mb~MECUTIVE E.L. DISEASE - EA EMPLOYEE $ 1 000 000 <br /> 11 ~es. describe ~nder EL DISEASE - POLICY LIMIT $1,000,000 <br /> S ECIAL PROV.!'lIONS below <br /> OTHER I <br /> , <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />IN THE EVENT 6F NON-PAYMENT OF PREMIUM, ONLY TEN(10) DAYS NOTICE OF CANCELLATION SHALL BE GIVEN. <br />PROJECT: SAryrA ANA FIXED GUIDEWAY SYSTEM <br /> I <br /> I <br /> : <br /> I <br />CERTIFICATE HOLDER CANCELLATION <br /> i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> , <br /> CLERK OF T~E CITY COUNCIL DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br /> CITY OF SA TA ANA NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> 20 CIVIC CENTER PLAZA (M-30) IMPOSE NO OBLIGATION OR LIABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> PO BOX 1 988 <br /> SANTA AN..( CA 92702 REPRESENTATIVES. ........... <br /> I AUTHORIZED REPRESENTATIVE ;Y DL ;t.u <br /> , <br />