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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 />