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ni6iI I-r a 1 Ll 1'G <br />ti dl-,Ui c.v1v Y . LU. -L / X" L-1 rr?\AL' ci vv0 Can .?ca vci <br />/} - ZCM - 00q <br />acoRnn CERTIFICATE OF LIABILITY INSURANCE 0DATE 1/28/21DD/YYYY) <br />01 /28/2010 <br />PRODUCER THIS CERTIFICATE I ISSUED AS A MATTER- OF INFORMATION <br />AUTOMATIC DATA PROC INS AGCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />71 HANOVER RD MS 625 - - HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />LO <br />H <br />AM <br />PA <br />R <br />K, NJ 07932 <br />? 1 ? ALTER HE COVERAGE AFFORDED Y THE POLICIES BELOW. <br />6 <br />O <br />2 <br />? <br />?? <br />`8 <br />j <br />XV770 70A INSURERS AFFORDING COVERAGE NAIC # <br />INSURED !A IAMA <br />CONSENSUS, INC C IT <br />INSURER ATRAVELERS CASUALTY AND SURETY COMPANY <br />626 WILSHIRE BLVD. #1000 cLERK Vii:. I,AoUNCIL INSURERB: <br />LOS ANGELES, CA 90017 INSURER C: <br /> INSURER D: <br />I INSURER E: <br />COVERAGES <br />I rtt VULll:lt5 OF IN51LIHANCE 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 SIIILIFrT TO Al I TN;: TrDLAC curl Ilclnwlc Aun rn?inlr,ru,a - <.,,..,, <br />rULIt,Ilz?l.ALjI,iHt:L:iiA It: LIMI IS SHOWN MAY HAVE BEEN REDUCED BY PAID C <br />- ------ <br />LAIMS. <br />INSR <br />LTR ADD' <br />INSR <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE <br />DATE M/DD/YY POLICY EXPIRATION <br />DATE MWDD/Y <br />UMITS <br /> GE NERAL LIABIITY <br /> O EACH OCCURRENC $ <br /> C <br />MMERCIAL GE NERAL LIAR ILff V <br /> CLAIMS MADE 7 OCCUR $ <br /> <br /> M=-D EXP An one person) $ <br /> P R NAL A DV INJURY <br /> <br /> GEN'L AGGR E GATE _IMITAPPLIES PER: <br /> PRO <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) $ <br /> ALL OWNED AUTOS N <br />BODILY I <br />URY <br /> <br />SCHEDULED AUTOS o <br />' $ <br /> HIRED AUTOS <br /> O D AS TO FO BODILY INJURY <br />(Per accident) <br /> NON-OWNED AUTOS App <br />1 $ <br /> I <br /> / <br />? <br />?- Pp DPE RTY DAMAGE <br /> L <br />• (Per accident) $ <br /> GARAGE LIABILITY Laura ShCedy AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO <br />Assistant <br />'ity Attorne <br />y <br />OTHERTHAN EA ACC <br />$ <br /> AUTO ONLY. AGG $ <br /> EXCESSIUMBRELLA LIABILITY <br /> EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> <br /> DEDUCTIBLE $ <br /> RETENTION $ <br /> $ <br />A WORKERS COMPENSATION AND UB-9081 C486-10 01/01/2010 01/01/ <br />11 X <br /> EMPLOYERS' LIABILITY 20 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED E.L. EACH ACCIDENT $1,000,000 <br /> ? <br />11 es, tlescribe under <br /> <br />E.L. DISEASE - EA EMPLOYEE <br /> <br />$1.000,000 <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDO <br />RSEMENT /SPECIAL PROVISIONS <br />IN THE EVENT OF NON-PAYMENT OF PREMIUM, ONLY TEN(10) DAYS NOTICE OF CANCELLATION SHALL BE GIVEN <br />. <br />PROJECT: SANTA ANA FIXED GUIDEWAY SYSTEM <br />CERTIFICATE HOLDER t'AAI!`CI I ATIAAI <br />CLERK OF THE CITY COUNCIL <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA (M-30) <br />PO BOX 1988 <br />SANTA ANA, CA 92702 <br />ACORD 25 (2001 /06) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />IUTHORRED REPRESENTATIVE <br />CORPORATION 1481