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- -I <br />lc J[ CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DD/YYYY) <br />7/6/2018 <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(les) 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 />LAURIE BRENNAN HAUCK <br />9114 Adams Ave #182 <br />Huntington Beach, CA 92646 <br />CONTACT <br />NAME: <br />PHONE F (702)-6700629 aAXNe:(702)629-6701 <br />E-MAIL JDrenco@aol.com <br />ADDRESS: <br />GENERAL LIABILITY <br />OC98533 <br />INSURERS AFFORDING COVERAGE NAIC# <br />INSURERA: Burlington Insurance Company <br />INSURED Aesco, Inc. <br />INSURER B: The Hartford 19666 <br />17782 Georgetown Lane <br />INSURER C: Houston Casualty Company <br />Huntington Beach, Ca 92647 <br />INSURER D: The Hartford <br />(714) 375-3830 <br />INSURER E: <br />INSURER F <br />COVERAGES CFRTIFICATF NLIMBFR RFVIRION NIIMRFR- <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 BYPAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />AUUL15UbK <br />INSR <br />WVD <br />POLICYNUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $2 000 000. <br />X COMMERCIAL GENERAL LIABILITY <br />PREMISES Ea occurrence $ 100 000. <br />MED EXP An one erson $ 5000 <br />CLAIMS -MADE r X r OCCUR <br />1 PERSONAL& ADV INJURY s2,000, 000. <br />A <br />y <br />15413W46127 <br />6/24/2018 <br />6/24/2019 <br />X <br />GENERAL AGGREGATE s2,000,000. <br />GEN'L AGGREGATE LIMITAPPLIES PER: <br />PRODUCTS - COMP/OP AGG s2'000,000. <br />POLICY 7 PRO LOC <br />$ <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT0,000. <br />Ea accident i <br />BODILY INJURY (Per person) $ <br />X'� ANYAUTO <br />72UECT(� 7770 <br />Q <br />'] / /20187/7/2019 <br />B <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />}{ <br />jt <br />BODILY INJURY (Per accident) $ <br />X HIRED AUTOS �{ NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE $ <br />Per accident <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LAB <br />CLAIMS -MADE <br />DED I I RETENTION <br />WORKERS COMPENSATION <br />- OTH- <br />}{ I WC STATUTORY <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE 1�1 <br />e <br />72WECKU6780 <br />4/11/2018 <br />/11/2019 <br />I FIR <br />E.L. EACH ACCIDENT $ 1,000,000 <br />D <br />OFFICER/MEMBER EXCLUDED? ILJI <br />NIA <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,0 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />1 0 0 0,500 <br />E.L. DISEASE -POLICY LIMIT r <br />C <br />Professional Liab. <br />HCC 1823089 <br />07/09/1807/09/19$2,000,000 <br />per claim <br />$2,000,000. aggregate <br />DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space 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 atta hed form. <br />Primary/Non Contributory wording applies per the attached form <br />REVIEWED BY: EUNICE HEREDIA (PG OF } <br />(`FRTIPI(:OTF wni r1FR rAKlr FI I ATIr)KI <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />y <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 />AUTHORIZESENTATIVE <br />20 Civic Center Plaza <br />Santa Ana, Ca 92701 <br />a as <br />%*y 1988-201IFACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />