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Client#: 25320
<br />KIMLHORN
<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE
<br />F DATE(MM/DD/YYYY)
<br />2/04/2016
<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 />Greyling Ins. Brokerage/EPIC
<br />3780 Mansell Road, Suite 370
<br />Alpharetta, GA 30022
<br />NCAMPCT
<br />Jerry Noyola
<br />PHONE -- FAX
<br />A/C, No, Ems: 770-552-4225 _ �c No): 866-550-4082
<br />E-MAIL err no re Iln com
<br />ADDRESS: l Y• Yola @g Y 9•
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC It
<br />INSURER A: National Union Fire Ins Co of P
<br />19445
<br />INSURED Kimley-Horn and Associates, Inc.
<br />P.O. Box 330
<br />Raleigh, INC 27636
<br />INSURER B : Commerce & Industry Ins. Co.
<br />19410
<br />INSURER C : New Hampshire Ins. Co.
<br />23841
<br />INSURER D : Lloyds of London
<br />085202
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 />LT R
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />9645227
<br />04/01/2015
<br />04/01/2016
<br />EACH OCCURRENCE
<br />$1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE 1:9 OCCUR
<br />PREMISES Ea oNco,'. ce
<br />$ 500,000
<br />MED EXP (Any one person)
<br />$25,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />X Contractual Liab
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGO
<br />$ 2,000,000
<br />POLICY FX PRO- X LOC
<br />JECT
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />4982985
<br />04/01/2015
<br />04/01/201
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X
<br />ANY AUTO
<br />X
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON-OWNED
<br />HIRED AUTOS X AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />PE
<br />Per accident)
<br />__
<br />$
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />BE020733086
<br />04/01/2015
<br />04/01/2016
<br />EACH OCCURRENCE
<br />_
<br />AGGREGATE
<br />_s5,000,000
<br />$5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION$10,000
<br />$
<br />C
<br />A
<br />AND EMPLOYERS' LIABILITY WORKERS COMPENSATION
<br />Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatary in NH)
<br />N I A
<br />39901450
<br />39901451
<br />04/01/2015
<br />04/01/2015
<br />04/01/201
<br />04/01/201
<br />X T STATU- OTH-
<br />T
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />D
<br />Prof. Liab
<br />P070831500
<br />04/01/2015
<br />04/01/201
<br />Per Claim $2,000,000
<br />Aggregate $2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Re: On -Call Agreements A-2015-171 & A-209-212. The City of Santa Ana, its officers, employees, agents &
<br />representatives are named as Additional Insureds with respects to General Liability where required by
<br />written contract. The above referenced liability policies with the exception of professional liability are
<br />primary & non-contributory where required by written contract. Separation of Insureds applies to the
<br />General Liability Policy. Umbrella Follows Form with respeQgr81 &y�Qpb>_Lqy. Lla �.Lfty
<br />See Attached Descriptions) /
<br />� tions p• ) i�i�/II�`pd0/�17�3Y: �/' �° '` EC.kNfCE I,IEV%EM(uG 0F
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />© 1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br />#S439773/M395703 JNOY1
<br />
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