|
ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />OAT)D YYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />03122112011(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(ies sA e ns S OGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsemen . A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTA T Ut
<br />NAME: ..
<br />Marsh Risk & Insurance Services
<br />PHONE 0 r L, i 1
<br />FAIIC
<br />CA License #0437153
<br />.
<br />IN No ) .
<br />EMAIL
<br />ADDRESS
<br />777 South Figueroa Street
<br />Los Angeles, CA 90017
<br />S 1,000,000
<br />Attn LosAngeles .CertRequest@Marsh.Com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC 0
<br />INSURER A; Zurich American Insurance Company
<br />16535
<br />06510- AECOM-01 -14 -15 ENTXT CA JWHITE ORANG CA
<br />INSURED
<br />AECOM USA, Inc. y
<br />INSURER B :
<br />INSURER c : Illinois Union Insurance Co
<br />27960
<br />flkla P&0 Consultants, Inc. ,�0 /D.CD /
<br />INSURER D; NIA
<br />NIA
<br />DWM+Hams, Inc
<br />�'n -/� O
<br />999 TOWN & COUNTRY RD., 4TH FL. ->
<br />$ 5,000
<br />PERSONAL &ADV INJURY
<br />['
<br />ORANGE, CA 92868 ft- /�y7jJld
<br />,I 7
<br />INSURER E:
<br />I INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: LOS-001365785 -49 REVISION NUMBER:
<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 WITH 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 />TYPEOFINSUILNCE
<br />INSR
<br />SUER
<br />POLICYNUMBER
<br />MM DDMYY
<br />MIDDMYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />GLO 5965891 06
<br />04/0112014
<br />0410112015
<br />EACH OCCURRENCE
<br />S 1,000,000
<br />X COMMERCIAL GENERALLIABILITY
<br />PREMSES EaEo rrfmce
<br />$ 1,000,000
<br />CLAIMS -MADE �] OCCUR
<br />MED UP (Any one person)
<br />$ 5,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />PRODUCTS - COMP /OP AGG
<br />$ 1,000,000
<br />$
<br />POLICY X PRO- 17 LOC
<br />JECT —1
<br />A
<br />AUTOMOBILE LIABILITY
<br />BAP 5965893 06
<br />M0112014
<br />0410112015
<br />COMBINED SINGLE LIMIT
<br />Ea a::cideN
<br />1,000,000
<br />BODILY INJURY (P., person)
<br />$
<br />X ANY AUTO
<br />BODILY INJURY (Per accitlent)
<br />$
<br />ALL OMFO SCHEDULED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />NON OWNED
<br />HIREDAUTOS AUTOS
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED FETE
<br />$
<br />I
<br />WORKERS COMPENSATION
<br />N/CSTATU- OTH-
<br />AND EMPLOYERS' LIABWTY YIN
<br />ANY PROPRIETORIPARTNEWEXECUTIVE
<br />E . EACH ACCIDENT
<br />$
<br />OFFICERMIEMBER EXCLUDED' ❑
<br />NIA
<br />(Mandatory In NH)
<br />E . DISEASE - EA EMPLOYE
<br />$
<br />E . DISEASE - POLICY LIMIT
<br />$
<br />It yes deMlhe.nder
<br />DESCRIPTION OF OPERATIONS Del.
<br />C
<br />ARCHITECTS & ENG.
<br />EON 621654693
<br />040112013
<br />1010812014
<br />Per ClaimlAgg $1,000,000
<br />PROFESSIONAL LIAB.
<br />'"CLAIMS MADE ""
<br />Defense Included
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is raqulvac) ^
<br />RE CITY EMPLOYEES, AGENTS, AND 4$�j r RAGES, BUT ONLY
<br />SUCH INSURANCE AFFORDED SHALL BEADDITIONl�,
<br />OF THE NAMED INSUREDS ANY I RT
<br />RESPECTS WORK PERFORMED BY OR ON �:�A1/$$uu��ff DANYI URANCE CARRIED BY CERTIFICATE
<br />HOLDER & ADDITIONAL INSURED SHALL BE EXCESS AND NOT CONTRIBUTORY INSURANCE FOR GENERAL LIABILITY C E. 'see pg.2
<br />e
<br />30se S t city pitasn Y
<br />Or I gi ®t$n
<br />CITY OF SANTA ANA
<br />CITY ATTORNEY
<br />20 CIVIC CENTER PLAZA f&29)
<br />P.O. BOX 1988
<br />SANTA ANA, CA 92702 -1988
<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 />AUTHORIZED REPRESENTATIVE
<br />of Marsh Risk & Insunancs Services
<br />David Denihan
<br />V 1838 -2010 AGUKU GUKPUKA 1 IUN. All rlgnrs reserVea.
<br />ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD
<br />
|