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A� �® CERTIFICATE OF LIABILITY INSURANCE
<br />DATEIYYYY)
<br />1
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />04109,120,
<br />2012 2
<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 />NAME:
<br />Marsh Risk & Insurance Services
<br />PHONE FAIC
<br />CA License 40437153
<br />NO),
<br />_
<br />E-MAIL
<br />ADDRESS'
<br />777 South Figueroa Street
<br />Los Angeles, CA 90017
<br />Attn: Lori Bryson (213)-346-5464
<br />INSURER(S) AFFORDING COVERAGE MAIC fl
<br />INSURER A : Zurich American Insurance Company 116535
<br />06510-AECOM-CAS-12113 Orange CA Daryl 4117
<br />INSURED
<br />Technical Services, Inc.
<br />INSURER B :
<br />INSURERC: Ilinois Union Insurance Cc 27960
<br />999 To
<br />999 Town &Country Road
<br />INSURER D: N/A N/A
<br />Orange, CA 92868
<br />INSURER E:
<br />INSURER F:
<br />G'OVLRAGFN CFRTIFICATF NIIMRFR' I n,;.nni,,nAiwLn1 RFVISIr1rJ NI IMRFR-
<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 />POLICY EFF
<br />MMID
<br />POLICY EXP
<br />MWD
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />GLO596589104
<br />04/01/2012
<br />04V/2013
<br />EACH OCCURRENCE $ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE Ex—J OCCUR
<br />DAMAGE TO R N 1,000,000
<br />PREMISES Ea occurrence $
<br />MED EXP (Any one person) $ 5,000
<br />PERSONAL & ADV INJURY $ 2,000,000
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG S 4,000,000
<br />X POLICY PRO LOC
<br />S
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />BAP 5965893 04
<br />104/01/2012
<br />04/01/2013
<br />Ea aB1 n SINGLE LIMIT $ 2,000,000
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Per person) S
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY Per accident $
<br />( )
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />eccid
<br />Per ert) $
<br />$ --
<br />UMBRELLA UAB
<br />OCCUR
<br />EACH OCCURRENCE $
<br />EXCESS LIAB
<br />CLAIMS -MAGE
<br />AGGREGATE S
<br />DED RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE —]E.
<br />OFFICER/MEMBER EXCLUDED?
<br />NIA
<br />WC STATU- OTH-
<br />T M TER
<br />DR
<br />L. EACH ACCIDENT $
<br />E.L. DISEASE • EA EMPLOYE $
<br />(Mandatory In NH)
<br />If yes, describe under
<br />E. L. DISEASE - POLICY LIMIT 1 $
<br />DESCRIPTION OF OPERATIONS bels«
<br />C
<br />ARCHITECTS & ENG.
<br />IEON
<br />G21654693
<br />10/08/2011
<br />04/01/2013
<br />Per Claim/Agg $1,000,000
<br />PROFESSIONAL LAB.
<br />"CLAIMS MADE
<br />Defense Included $2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required)
<br />RE: JOB NO: 60196303 - Santa Ana Grade Separation Project.
<br />THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES, AGENTS, REPRESENTATIVES, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED FOR GL & AL COVERAGES, BUT ONLY AS
<br />RESPECTS WORK PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. A WAIVER OF SUBROGATION IS PROVIDED FOR THE GENERAL LIABILITY AND AUTO LIABILITY COVERAGES. SUCH
<br />INSURANCE AFFORDED SHALL BE PRIMARY INSURANCE AND ANY INSURANCE CARRIED BY CERTIFICATE HOLDER & ADDITIONAL INSURED SHALL BE EXCESS AND NOT CONTRIBUTORY
<br />INSURANCE FOR GENERAL LIABILITY AND AUTO LIABILITY COVERAGE.
<br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />PUBLIC WORKS AGENCY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ATTN: JASON GABRIEL C ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 CIVIC CENTER PLAZA, M-36
<br />SANTA ANA, CA 92701 :c1Y
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh Risk & Insurance Services
<br />David Denihan
<br />W 19138-Zv10 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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