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" - - --- CERTIFICATE OF
<br />LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />7/12/2016
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
<br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />TYPE OF INSURANCE
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,
<br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />POLICY NUMBER
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE
<br />A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />LIMITS
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />GENERAL LIABILITY
<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
<br />endorsement. Astatement on this certificate does not confer rights to the
<br />EACH OCCURRENCE s2,000,000.
<br />certificate holder in lieu of such endorsement(s).
<br />Yi COMMERCIAL GENERAL LIABILITY
<br />PRODUCER
<br />LAURIE BRENNAN HAUCK
<br />9114 Adams Ave #182
<br />NAME:
<br />PHONE
<br />A/C,No, EXt: (702)629-6700 (NC,Ne):(702)629-6701
<br />-MAIL
<br />ADDRESS: brenGO@aol brenco@aol.com
<br />Huntington Beach, CA 92646
<br />OC98533
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A: The Hartford
<br />INSURED Aesco, Inc.
<br />INSURER B: Trumbull Insurance Company
<br />19666
<br />17782 Georgetown Lane
<br />INSURER C: Houston Casualty Company
<br />Huntington Beach, Ca 92647
<br />INSURER D:
<br />(714) 375-3830
<br />6/24/2016
<br />INSURER E:
<br />PERSONAL &ADV INJURY s2,000,000.
<br />INSURER F:
<br />X
<br />Y
<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 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 />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />- POLICY EFF
<br />(MM/DD/YYYY)
<br />POLICY EX
<br />(MM/DD/YYYY)
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE s2,000,000.
<br />Yi COMMERCIAL GENERAL LIABILITY
<br />PREMISES (Ea occurrence) $ 100,000.
<br />MED EXP (Anyone person) $ 5000
<br />CLAIMS -MADE I OCCUR
<br />I ""
<br />A
<br />154BW35919
<br />6/24/2016
<br />6/24/2017
<br />PERSONAL &ADV INJURY s2,000,000.
<br />X
<br />Y
<br />GENERAL AGGREGATE $2,000,000.
<br />F
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG s2,000,000.
<br />POLICY PRO LOC
<br />JECT
<br />$
<br />_
<br />AUTOMOBILE LIABILITY
<br />Ea accident $1, 000,000.
<br />X ( ANYAUTO
<br />BODILY INJURY (Per person) $
<br />ALLOWNED SCHEDULED
<br />72UECTQ7770
<br />7/7/2016
<br />7/7/2017
<br />BODILY INJURY Per accident)$
<br />(
<br />.A
<br />AUTOS AUTOS
<br />}{
<br />Y
<br />NON -OWNED
<br />X X
<br />PROPERTY DAMAGE '
<br />$
<br />HIRED AUTOS AUTOS
<br />(Per accident)
<br />UMBRELLA LAS OCCUR
<br />EACH OCCURRENCE $
<br />EXCESS LIAB CLAIMS -MADE
<br />AGGREGATE $
<br />DED RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />X I WC STATU- OTH-
<br />AND EMPLOYERS' LIABILITY Y/N
<br />TORY LIMITS ER
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />B
<br />ANY PROPRIETOR/PARTECUTIVE ❑
<br />N/A
<br />4/11/2016
<br />4/11/2017
<br />OFFICER/MEMBER EXCLUUDED?DED'
<br />(Mandatory In NH)
<br />72WECKU6780
<br />E.L. DISEASE - EA EMPLOYEE $ 11000,000
<br />Ifyes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,00
<br />C
<br />Professional Liab.
<br />HCC 16 22130
<br />07/09/16
<br />07/09/17
<br />$2,000,000.per claim
<br />$2,000,000. aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS ( VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if morespace is required)
<br />RE: RFP15-055 Geotechnical, special inspection & material testing
<br />A-2011-057-01 for inspection & testing services
<br />A-2016-111 for inspection & testing services
<br />Certificate holder is named as an additional insured per the attach d form
<br />Primary/Non Contributory wording applies per the attached form
<br />..... --... .
<br />� ...__..
<br />REVIEWED E C (P, C)/)�
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Its Officers, Employees, Agents
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Volunteers and Representatives
<br />AU REPRES NTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana, Ca 92701
<br />© 198872010 ACORD CORPORATION. All rights reserved.
<br />ACORD25 (2010/05) The ACORD name and logo are registered marks of ACORD
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