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AC'ORO TM CERTIFICATE OF LIABILITY INSURANCE Dat 9�MM /QDD/vR) <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 BELOW. <br />THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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 the terms <br />and conditions of the policy, certain policies require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of <br />such endorsements . <br />PRODUCER <br />CONTACT <br />Heffernan Insurance Brokers <br />License No. 0564249 <br />NAME: <br />A/ONo.Ext : 7'14- 997 -8'100 <br />ac,NO : 7'1 a -460 -9935 <br />1 855 W. Katella Ave., Ste 255 <br />EMAIL <br />Orange, CA 92867 <br />ADDRESS: ' <br />EACH OCCURRENCE <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />INSURER A: <br />Travelers Pro a Casual[ Co <br />25674 <br />T 8c B Planning <br />INSURER B: <br />Travelers Indemni Co of America <br />25666 <br />17542 E. 17L1' St., Ste 100 <br />INSURER C: <br />Continental Casualt Co. <br />20443 <br />INSURER D: <br />Q2 /Qt /� � <br />Q2 /Q'I /'12 <br />- fLLSt1R, CA 927$0 <br />INSURER E: <br />INSURER F: <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABCVC- FOR THE PGLiCY PERIOD INDICATED. <br />NOTWITHSTP.NDI!•JG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSU RANGE <br />ADDL <br />INSR <br />SUER <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM /DDKWV <br />POLICY EXP <br />MM /DD/1'1'VY <br />LIMITS <br />�:!i'/ /"'� <br />GENERAL L LIABILITY <br />EACH OCCURRENCE <br />52,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />68O7OSOPOS'I <br />O2 /O'I /� 'I <br />O2 /O'I /'12 <br />DAMAGE TO RENTED <br />PREMISES (Ee occunanca) <br />gt 000.000 <br />B <br />CLAIMSMADE n OCCUR <br />6807080P536 <br />Q2 /Qt /� � <br />Q2 /Q'I /'12 <br />MED EXP (Any one parson) <br />$10,000 <br />PERSONAL &ADV INJURY <br />52,000,000 <br />GENERAL AGGREGATE <br />$4,000.000 <br />GEN'L. AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMP /OP AGG <br />54,000,000 <br />POLICY X PROJECT LOG <br />$ <br />A <br />AUTOMOBILE <br />LIABILITY <br />6807080 PO5'I <br />Q2 /Q� /� � <br />Q2 /Q'I /� 2 <br />COMBINED SINGLE LIMIT <br />(Ea accitlant) <br />$Intl in GL <br />BODILY INJURY (Per person) <br />$ <br />B <br />ANY AUTO <br />6807080P536 <br />Q2 /Q� /�� <br />Q2 /Qt /12 <br />ALL OWNED AUTOS SCHEDULED <br />AUTOS <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />BODILY INJURY (Per eccitlenl) <br />$ <br />X <br />PROPERTY DAMAGE <br />(Par accident) <br />$ <br />5 <br />CUP7080P6�6 <br />Q2 /Q� /�'I <br />Q2 /Q'1 /'12 <br />X <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$2,000,000 <br />A <br />EXCESS LIAR <br />CLAIMSMADE <br />AGGREGATE <br />$2,000,000 <br />DED X RETENTION SO <br />5 <br />WORKERS COMPENSATION <br />ANU EMPLOYERS' LIAaILITY Y /rJ <br />X WC STATU- OTH- <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />A <br />ANV PROPRIETOR/PARTNER/EXECUT /VFJ <br />OFFICER/MEMBER EXCLUDED? � <br />U63393T344 <br />02/01/11 <br />02/01/12 <br />E.L. DISEASE - EA EMPLOYEE <br />81,000.000 <br />(Mantlelory in N.H.) <br />Ir yes, tlescnbe untler DESCRIPTON OF <br />OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$1,000.000 <br />C <br />Professional Liability <br />MCH288294'144 <br />09 /20 /t'I <br />09/20/'12 <br />Per Claim <br />Aggregate <br />si.000.000 <br />s�,000,000 <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Adtlltional Ramarhs Schedule, H more space fa required) <br />Projects as on file with the insured including but no[ limited to San Lorenzo Lift Station 8c San Lorenzo Lift Station MN D. City of Santa Ana is named as additional insured <br />on eneral liabilt olic -see attached endorsement. <br />AS 'r� F <br />LBEIDELIVE <br />ty APP RC�� Y_.1� <br />Ci of Santa Ana <br />E�XP�IRADTIONYDATE THEREOF, NOTICEBWIL REDnIN ACCORDANCE WITH <br />PUb11C WOrkS Agency �� <br />THE POLICY PROVISIONS. <br />Corporate Yard, M -84 /! <br />ED REPRESENTATIVE <br />220 S. Daisy Ave. <br />Santa Ana, CA 92703 Laura S iu _ heedY <br />Assistant City Att Dine <br />�:!i'/ /"'� <br />AL..VKU �a lcu�u /uaJ VI- tl -ZVIU AGVKU LiVKYV KA I IVN. All ngnrs reserves. <br />The ACORD name and logo are registered marks of ACORD <br />