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A� �® CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2
<br />06/01/20 )
<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)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
<br />CONTACT
<br />Willis Insurance Services of California, Inc.
<br />26 Century Blvd.
<br />PHONE FAX
<br />No,FxT). 877-945-7378 888-467-2378
<br />E-MAIL certificates@willis.com
<br />P. 0. Box 305191
<br />Nashville, TN 37230-5191
<br />INSURER(S)AFFORDINGCoVERAGE
<br />NAIC#
<br />INSURER& National Union Fire Ins Co of Pittsburgh
<br />19445-100
<br />INSURED
<br />URS Corporation dba URS Corporation Americas
<br />INSURERB:Zurich American Insurance Company
<br />16535-100
<br />INSURERC:Illinois National Insurance Co.
<br />23817-001
<br />2020 E. First Street, Suite 400
<br />Santa Ana, CA 92705
<br />INSURER D:insurance Company of the State of PA
<br />19429-100
<br />INSURER E: Lexington Insurance Company
<br />19437-000
<br />INSURER F: Lloyd's of London & British Companies
<br />15792-004
<br />COVERAGES CERTIFICATE NUMBER: 16028973 REVISION NUMBER:See Remarks
<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 />TYPE OF INSURANCE
<br />wynPOLICY
<br />NUMBER
<br />POLICY EFF
<br />POLICY EXPLIMITS
<br />A
<br />GENERAL LIABILITY
<br />�OD'LSUB
<br />GL4870829
<br />5/1/2011
<br />6/1/2012
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />PREMISES Eaoccurence
<br />$ 1 000 000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />ME D EXP (Any one person)
<br />$ 10,000
<br />PERSONAL SADVINJURY
<br />$ 2,000,000
<br />X XCU, BFPD
<br />X
<br />Contractual Liability
<br />GENERAL AGGREGATE
<br />$ 2,)00,000
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />PRODUCTS -COMP/OPAGG
<br />$ 2 000000
<br />POLICY X PRO- LOC
<br />$
<br />B
<br />AUTOMOBILE LIABILITY
<br />BAP938521502
<br />5/1/2011
<br />6/1/2012
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 2,000,000
<br />BODILY INJURY(Per person)
<br />$
<br />X ANYAUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY(Per accident)
<br />$
<br />HIREDAUTOS NON -OWNED
<br />AUTOS
<br />PROPERTYDAMA E
<br />(Per accident)
<br />$
<br />$
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />Is
<br />C
<br />WORKERS COMPENSATION
<br />WC20635052
<br />1/1/2011
<br />1/1/2012-
<br />A
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER/EXECU I IVE
<br />N/A
<br />WC20635051
<br />1/1/2011
<br />1/1/2012
<br />E.L. EACH ACCIDENT
<br />$ 2,000,000
<br />C
<br />D
<br />OFFICER/MEMBER EXCLUDED?
<br />n NH)
<br />((Mandatory. 11T.
<br />ff yes, descnbe under
<br />I DESCRIPTION OF OPERATIONS below
<br />�WC20635054/WC20635055
<br />WC20635053
<br />1/1/2011
<br />1/1/2011
<br />1/1/2012
<br />1/1/2012
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 2,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 2,000,000
<br />E
<br />F
<br />Professional Liability
<br />015438088
<br />PE1105150/PE1105490
<br />5/1/2011
<br />5/1/2011
<br />6/1/2012
<br />6/1/2012
<br />$1,000,000 Each Claim
<br />w/Limited Contractual -
<br />$1,000,000 Aggregate
<br />Claims Made Policy
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required)
<br />THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 5/31/2011 WITH ID: 16021742
<br />The Workers' Compensation coverage shown above does not apply in monopolistic states. In the
<br />States of ND, OH, WA and WY, Workers' Compensation coverage is provided by the State Fund. In
<br />those States, the above -referenced policies provide Stop -Gap Employers' Liability only.
<br />SEE ATTACHED
<br />CERTIFICATE HOLDER �l 1 1-ii /A,) 1 11 flL)Ic,;A CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />4La,Wra
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ht $ ecdy 4 -
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />ASS1 t t Ctly Ai(urt,,_,
<br />City of Santa Ana
<br />20 Civic Center Plaza - Rose Annex (M-36)
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />4,_�_
<br />Coll:3376174 Tpl:1261289 Cert:16028973©1988-2010ACORDICORPORATION.All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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