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ACOROe <br />f%CCT101f`ATC nlr 1 IArms DATE IMI MIDEVYYW1 1 <br />A� �® <br />CERTIFICATE OF LIABILITY INSURANCE <br />GATE (MM DDIYYYY) <br />lo/e/zolo <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 po(icy(Iss) must be endorsed. 11 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 />Ames and Gough <br />450 Northridge Parkway <br />Suite 102 <br />NAM JEirry NOyOla <br />PHONE (770) $52 -4225 _ INC No) <br />ADDeILRSJJnoyola @ameegough.com J <br />PRODUCER OOQ01398 <br />Atlanta GP. 30350 <br />INSURERS AFFORDING LOVEMGE NAICM <br />_ <br />INSURED <br />INSURERATrayelers Indemnity Co. of CT <br />CURRENCE <br />INSURER BTraveler9 Indemnit Company <br />_ <br />$ 1,000,000 <br />INSURER C:Travelers Property Casualt Co. <br />Kimley -Horn and Associates, Inc. <br />A <br />INSURER D Phoenix Insurance Com an <br />__y -- <br />P.O. Box 33068 <br />INSURER ETravelers_Prop. Cas. Cc America <br />9/1/2010 <br />9/1/2011 <br />Raleigh NC 27636 <br />INSURER F: <br />COVERACES f`FRTIFICATF MIIMRFRQO -11 ( Kimlev Jessica) REVISIONNUMBER: <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 TYPE OF INSURANCE <br />TR <br />POLICY NUMBER <br />MAMIDD <br />MMIDOYEXP <br />UMnS <br />GENERAL LA &LITY <br />LL <br />X COM MERCIAL GENERAL <br />CURRENCE <br />E 1,000,000 <br />tPREMISES E.0 ,ence) <br />$ 1,000,000 <br />n one wmrs l <br />S 10,000 <br />A <br />CLAIMS -MADE �" OCCUR <br />630- 315X3476- TCT -30 <br />9/1/2010 <br />9/1/2011 <br />PERSONALS ADV INJURY <br />IE 1,000,000 <br />GENERAL AGGREGATE <br />S 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS- COMP/OP AGO <br />5 1,000,000 <br />S <br />POLICY X PRO- X LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea udder) <br />E 1,000,000 <br />BODILY INJURY (Per permn) <br />S <br />B <br />X <br />H <br />ANY AUTO <br />ALL OMED AUTOS <br />510- 171L6115- RD -10 <br />9/1/2010 9/1/2011 <br />BODRY INJURY (Per ewdeni) <br />- <br />E <br />_ <br />I X <br />SCHEDULED AUTOS <br />HIREDAUTOS <br />Q <br />Tp I� M <br />PROPERTY DAMAGE <br />(Perewtlem) <br />E <br />Undedrsured nlmWK Bl vid <br />S <br />X <br />NON -O NED AUTOS <br />Uninsured Irmnsl pmwe <br />S <br />X UMBRELLA UAB X' OCCUp <br />EXCESS UAB CL41MS-MADE <br />II A ' <br />i <br />EACH OCCURRENCE <br />5 5,000,000 <br />H C' <br />y Atlof9e <br />AGGREGATE <br />S 5'000,000 <br />E _ -- <br />DEDUCTIBLE <br />y <br />C <br />X <br />RETENTION 5 10 000' <br />- 17IL6115 -T -10 <br />9/1/2010 9/1/2011 <br />D <br />E <br />INORNERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNER /EXECUTIVE YIN <br />OFFILERAIEMBER EXCLUDED? <br />(ManWrOry In NH) <br />NIA <br />C- 536GB753 -SO <br />- 83668783-10 (CA) <br />'9/1/201D <br />9/1/2010 <br />'9/1/2011 <br />9/1/2011 <br />X WC STATU- 0TH -I <br />CH ACCIDENT <br />$ 500000 <br />DISEASE -EA EMPLOYE <br />S 500 000 <br />E.L. DISEASE - POLICY LIMIT <br />E 500,000 <br />lye dPT-18NuMder <br />DESCRIPTION OF OPERATIONS Oebw <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANacN ACORD 101, A4dNN1ul RamareN Schs4uN, If mom specs is mqulretl) <br />Re: Project - Consulting Contract City of Santa Ana. The City of Santa Ana, its officers, employees c Volunteers are <br />named as Additional Insureds on the above referenced liability policies with the exception of workers compensation f <br />professional liability. Umbrella Follows Form. <br />City of Santa Ana <br />Planning Division <br />P.O. Box 1968 <br />M -20 <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Ormaza /JOSH <br />11450Z* (20 ) I ne FlN VMLF Dame anM IONS era rograILUMU mares m ^V.v <br />