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Client #: 4072f TR NMI ACORO;�., CERTIFICATE OF LIABILITY INSURANCE M/DDIYYYY) NSRI 3 /091 03109/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION USI of Southern California ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lic # 0351162 29A Technology Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. GENERAL LIABILITY 72SBAAB7543 Irvine, CA 92618 INSURERS AFFORDING COVERAGE NAIC 4 INSURED T B PLANNING, INC. 1755 42 E. 17TH ST., #100 TUSTIN, CA 92780 INSURER A. Hartford Casualty Insurance Company 29424 INSURER B Twin City Fire Insurance Company. 29459 INSURER C INSURER D. INSURER E' S1 O 0,00 PERSONAL & ADV INJURY COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR NSRI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMtDDIYYI POLICY EXPIRATION DATE MM/DD LIMITS A GENERAL LIABILITY 72SBAAB7543 03/12/10 03/12111 EACH OCCURRENCE s2,000,000 DAMAGE T R oNTED $300 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR MED EXP (Any one person) S1 O 0,00 PERSONAL & ADV INJURY s2,000,000 GENERAL AGGREGATE s4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG s4,000,000 - POLICY PRCOT- LOC A AUTOMOBILE LIABILITY ANY AUTO 72SBAAB7543 03/12/10 03/12/11 COMBINED SINGLE LIMIT (Ea accdenO $2,000,000 ALL OWNED AUTOS SCHEDULED AUTOS L, APPROVED A 7� ,l 1O FOR BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS - X BODILY INJURY (Peraccidenl) X Laur titt Shee.dy ASS1St t L.lt ) Attorney PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S THAN EA ACC S ANY NY AUTO $ AUTO ONLY AGG A EXCESS/UMBRELLA LIABILITY X OCCUR F-1 CLAIMS MADE 72SBAAB7543 03/12/10 03/12/11 EACH OCCURRENCE s2,000,000 AGGREGATE s2 OOO OOO S s DEDUCTIBLE X RETENTION $10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 72WECFV9256 08/13/09 08/13/10 X I VJC STATU- OTH- 1 FIR E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? II es. y SPECIdescribe under AL PROVISIONS below E.L. DISEASE - EA EMPLOYEE 1$1,000,000 S1,000,000 E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS *30 day cancellation notice except 10 days notice for non - payment of premium. Re: Project #788 -002, San Lorenzo Lift Station. The City of Santa Ana, its officers and employees are named as additional insureds with respects to General Liability as per policy form SS00080405. (See Attached Descriptions) City of Santa Ana Public Works Agency Corporate Yard, M -85 200 S. Daisy Avenue Santa Ana, CA 92702 ar npn 9S i,)nn1 R1R1 w _r n nn. —.u....,.... Iw.... lulaeI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL •In DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ,-. .. - X . JIVIVVJU W „'Vrcu %1V1[MVrtAI IVIV Tubb