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CAI ORO TM CERTIFICATE OF LIABILITY INSURANCE Date /1/201DnrR)
<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(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 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 endorsement(s).
<br />PRODUCER CONTACT
<br />Heffernan Insurance Brokers NAME:
<br />License No. 0564249 A/CONo,Ext: 714-997-8100
<br />FAX
<br />No : 714-460-9935 JC,
<br />1855 W. Katella Ave., Ste 255 EMAIL
<br />Oran
<br />CA 92867
<br />e ADDRESS:
<br />g
<br />,
<br /> INSURERS AFFORDING COVERAGE NAIC #
<br />INSURED INSURER A: Travelers Property Casual Co 25674
<br />T & B Planning INSURER B: Travelers Indemnity Co of America
<br />17542 E. 17' St.
<br />Ste 100 INSURER C: Continental Casual Co. 20443
<br />,
<br />Tustin
<br />CA 92780 IN-CURER D:
<br />, INSURER E:
<br /> INSURER F:
<br />GOVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
<br />NOTWITHSTANDING 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 7ypE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br />LTR INSR WVD MM/DD MM/DD
<br /> GENERAL L LIABILITY EACH OCCURRENCE $2,000,000
<br />A X COMMERCIAL GENERAL LIABILITY
<br />680708OP051
<br />02/01/11
<br />02/01/12
<br />DAMAGE TO RENTED
<br />$1
<br />000
<br />000
<br /> PREMISES (Ea occurrence) ,
<br />,
<br />B CLAIMS-MADE I "I OCCUR 680708OP536 02/01/11 02/01/12 MED EXP (Any one person) $10,000
<br /> PERSONAL & ADV INJURY $2,000,000
<br /> GENERALAGGREGATE $4,000,000
<br /> GEN'L. AGGREGATE LIMIT APPLIES PER PRODUCTS -COMP/OP AGG $4,000,000
<br /> POLICY X PROJECT LOC $
<br />A AU TOMOBILE LIABILITY 680708OP051 02/01/11 02/01/12 COMBINED SINGLE LIMIT $Incl in GL
<br /> (Ea accident)
<br />B ANY AUTO 680708OP536 02/01/11 02/01/12 BODILY INJURY (Per person) $
<br /> ALL OWNED AUTOS SCHEDULED
<br />AUTOS
<br />BODI LY I NJURY(Per accident)
<br />$
<br /> X HIREDAUTOS X NON-OWNED PROPERTY DAMAGE
<br />$
<br /> AUTOS (Per accident)
<br />
<br /> X UMBRELLA LIAR OCCUR CUP708OP616 02/01/11 02/01/12 EACH OCCURRENCE $2,000,000
<br />A EXCESS LAB CLAIMS-MADE AGGREGATE $2,000,000
<br /> DEC) X RETENTION $0 $
<br /> WORKERS COMPENSATION WC STATU- OTH-
<br />X
<br /> AND EMPLOYERS' LIABILITY - Y/N TORY LIMITS ER
<br />
<br />A ANY PROPRIETORPARTNERiEXECUTIVE/
<br />OFFICER/MEMBEREXCLUDED?
<br />UB3393T344
<br />02/01/11
<br />0
<br />/ E.L. EACH ACCIDENT $1,000,000
<br />
<br />(Mandatory in N.H.) N 2
<br />01/12
<br />E
<br />L
<br />DISEASE - EA EMPLOYEE
<br />$1
<br />000
<br />000
<br /> If
<br />es
<br />describe under DESCRIPTION OF .
<br />. ,
<br />,
<br /> y
<br />,
<br />OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000
<br />C Professional Liability MCA288294144 09/20/10 09/20/11 Per Claim $1,000,000
<br /> Aggregate
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Projects as on file with the insured including but not limited to San Lorenzo Lift Station & San Lorenzo Lift Station MND. City of Santa Ana is named as additional insured
<br />on eneral liability policy-see attached endorsement.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana i
<br />? ^ =1r ; ;.
<br />x k , SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
<br />Public Works Agency
<br />Corporate Yard
<br />M-84 THE POLICY PROVISIONS.
<br />,
<br />220 S. Daisy Ave. AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92703
<br />__WM" `V t`V'urVUr ©1-8-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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