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ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDIYYYY) <br />F <br />8(30/2012THIS <br />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 Garrett/Mosier/Griffith/Sistrunk <br />CONTkctdAME: <br />PHONE A/C No <br />Risk Management & Insurance Services <br />12 Truman <br />GENERAL LIABILITY <br />Irvine, CA 92620 <br />E-MAIL ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A: Travelers It America <br />www.gmgs.com OB84519 <br />INSURED <br />Tait & Associates, Inc. <br />Tait Environmental Services, Inc. <br />INSURER B: <br />INSURERC: <br />INSURER D: <br />701 Parkcenter Dr. <br />Santa Ana CA 92705 <br />INSURER E: <br />INSURER F: <br />MED EXP (Any one person) $ <br />COVERAGEC CERTIFICATE NUMBER: 13984070 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 />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />MM/DD//YYYY CY EFF <br />MMLDD//YYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />COMMERCIAL GENERAL LIABILITY <br />PREMISES E. occccurrenoe $ <br />MED EXP (Any one person) $ <br />CLAIMS -MADE F—I OCCUR <br />PERSONAL 8 ADV INJURY $ <br />GENERAL AGGREGATE $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ <br />$ <br />POLICY PRO <br />LOC <br />A <br />AUTOMOBILE <br />LIABILITY <br />810 -7138R642 -TIL -12 <br />9/1/2012 <br />9/1/2013 <br />EOa aBINEDISINGLE LIMIT $ 1,000,00 <br />BODILY INJURY (Per person) $ <br />✓ <br />ANY AUTO <br />BODILY INJURY (Per accident) $ <br />✓ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIRED AUTOS ✓ AUTOS <br />PROPERTY DAMAGE <br />Per accident $ <br />$ <br />$1,000 Comp. Ded. <br />$1,000 Coll. Ded <br />$ <br />UMBRELLA LIAB <br />- -..� }•.. y ' <br />-EACH OCCURRENCE $ <br />EXCESS LIAB <br />HOCCUR <br />CLAIMS -MADE <br />'�`-� - !I , <br />_ ,. -' <br />AGGREGATE $ <br />DED RETENTION $ <br />$ <br />,- <br />_ <br />$ <br />_ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />UB -7244R703 -TIL -12 <br />9/1/2012 <br />9/1/2013 <br />1WC STATU- 0 - <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT $ 1,000,000 <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />N / A <br />E.L. DISEASE - EA EMPLOYEFJ $ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT I $ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />RE: UST Removal next to City Hall <br />CERTIFICATE HOLDER <br />CANCELLATION <br />RE: UST Removal next to City Hall <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />Office of the City Attorney <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />PO Box 1988 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 <br />Michael Finn <br />©1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />CERT NO.: 13984070 Charise Eberhard 8/30/2012 12:23:41 PM Page 1 of 1 <br />