ALBERT GROVER & ASSOCIATES -2010

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. le. R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Insurance Office of America CONTACT NAME: 130 Vantis, Suite 250 Aliso Viejo, CA 92656 PHONE • 949- 297 -5962 A/c No - 949 - 297 -5960 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC 6 6$025981-177 INSURERA: Travelers Propedy Casualty Ins Co of America 25674 www.ioausa.com CA License #OE67768 INSURED Albert Grover & Associates, Inc. 211 E. Imperial Highway, Suite 208 Fullerton CA 92835 INSURER B : Travelers Casualty & Surety Co of America 31194 INSURER C Scheduled Al Endt #CGD3820907 Professional Services INSURER D $ 1,000,000 INSURER E: $ 10,000 PERSONAL & ADV INJURY INSURER F : ✓ Primary/Non - Contributory COVERAGES CERTIFICATE NUMBER: 8705605 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM /DD LIMITS • GENERAL LIABILITY V 6$025981-177 7/1/2010 7/1/2011 EACH OCCURRENCE $ 1,000,000 ✓ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:21 OCCUR Scheduled Al Endt #CGD3820907 Professional Services DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 ✓ Primary/Non - Contributory performed by the insured ✓ Waiver of Subrogation are Excluded GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY FV PRO- ✓ LOC • AUTOMOBILE LIABILITY 68025981-177 7/1/2010 7/1/2011 COMBINED B ISINGLE LIMIT (Ea $Included in GL BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS 8 AUTOS NON -OWNED HIRED AUTOS ✓ AUTOS �, I -' BODILY INJURY Per accident) ( $ ✓ PROPERTY DAMAGE per. acci(ai $ $ ul A UMBRELLA LIAB ✓ OCCUR CUP6677Y247 i.ti'lSl 9%'/II /200 y, 71%2011 EACH OCCURRENCE $ 2000000 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE Excludes Professional Liability ✓ DED RETENTION$O $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑Y N/A ✓ U66676Y748 Blanket Waiver of Subrogation Endt 7/1/2010 711/2011 wcsTAru- o - TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000.00 0 E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under #WC99037600 E.L. DISEASE - POLICY LIMIT I $ 1000.00 DESCRIPTION OF OPERATIONS below B Professional Liability 105306576 7/1/2010 7/1/2011 $2,000,000 Per Claim Claims -Made $4,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, U more space is required) Certificate Holder is an Additional Insured with respect to General Liability but only when required by written contract with the Named Insured prior to an occurrence as per Endorsement(s) noted above. General Liability includes Separation of Insureds and Contractual Liability per limitations in the Liability Coverage form #CG00011001. A Workers' Compensation Blanket Waiver as noted above is included for all persons or organizations that are parties to a contract that require this Endorsement, provided that contract is executed before the loss. Coverage is subject to all policy terms, conditions limitations and exclusions. 30 Day Notice of Cancellation /10 Dav Notice for Non-Payment of premium. CERTIFICATE HOLDER CANCELLATION 2010 Citywide Engineering and Traffic Survey SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza, M-43 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE (AVC) Alicia K. Igram ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO : B/OS605 Pauline Bingham 11/2/2010 9:56:15 AM Page 1 of 4