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ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MRVDD/`nn'Y) 5/23/20'12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditlona of the policy, certain policies may require an endorsement A statement on this certificate does not confer rig his to the certificate holder in lieu of such sndorsemen s . PRODUCER NAME: Wood Gutmann 8 Bogart Lic #0679263 ? ` 1 J 2 PHONE FAX - c ? ' _ ' r 9 ? -MAIL 1590'1 Red Hill Ave., Suite '100 'V ? Imo. DRES Tustin CA 927$0 _ _ INSURER(S) AFFORDING COVERAGE NAIC Y _ INSURER A INSURED ARELL-1 INS URERB:HartfOfd ACCldent and Arellano Associates INSURERC:PhlladelDhla Indemnity Ins Co Genoveva Arellano __ 13791 Roswell Av S it A/B INSURER D -- e u e - Chino CA 91710 INSURER E ___ .. __ INSURER F _ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTq TYPE OF INSURANCE POLICY EFF POLICY EXP -_- -_- -- -_-- - __-- 1 WVD POLICY NUMBER / / LIMITS A GENERAL LIABILnY PAS037514693 28/2012 /26/20'13 EACH OCCURRENCE 52,000.000 X COMMERCIAL GENERAL LIABILITY PREMISES Ee occtsianrs 52,000,000 CLAIMS MADE ? OCCUR - MED EXP An one person) E10,000 PERSONALBADV INJURY 52000 000 , _ GENERAL AGGREGATE E4 000 000 _ , _ GE N'L AGGREGATE LIMIT APPVES PER' PRODUCTS -COMP/OP AGG _..._ _ E4,000?00 POLICY PRO- '' LOC E _? _. A AUT OMOBILE LIABILITY PA5037514693 /28/2012 /26/20'13 Ee ear tlant 1 000 000 ANY AUTO BODILY INJURY (Per parson) _ E ALL OWNED SGHE DV LED X B I Y I RY _ AUTOS AUTOS OD L NJU (Per ecCitlant) S X ? HIR D AUTOS NON -0WNED X PROPERTY DAMAGE -? E A O (Par acdtlentl y E A I UMBRELLA LIAB X OCCUR ?'. PA5037514693 /26/20'12 /26/2013 EACH OCCURRENCE 51,000,000 EXCESS LU1B CLAIMS-MADE I AGGREGATE 5 _ DED X RETENTION 50 y B WORKERS DOMpEN$ATON 2WECD00297 /27/2012 27/20'13 KC STATU- OTH- X AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE I N I A OFFICE R/M EMBER EXCLUDED? ? ? E.L. EACH ACCIOE NT E1 000 000 , (MAntlalPry In NH) I If tl ib tl E.L. DISEASE - EA EMPLOYE St 000,000 es, ascr a an er I D SC RIPTION OF OPERATIONS balew E.L. DISEASE -POLICY LIMIT Sl 000 000 C A Errors 8 Ommissions PMS D736305 /8/2012 /6/2013 2,000 000/Claim 2,000,000/AB0 Valuable Pa pars 8 Records PAS0375t4693 /26/2012 /26/2013 25,000 DESCRIPTION OF OPERATONS /LOCATIONS /VEHICLES (A1LCh ACORD 101, AtltlitlonAl Remedce Schetlule, H mono epeoe le repo re ? '' Job: Warner Avenue Widening Project Job No: N-2012-011 / Certificate holder is named as additional insured on the General Liability per attached 9S2001.1)A-99?- ..__ ? ura Srar SIT edy Primary and Non-Contributory applies on the General Liability per attached 9S2001 04 99 ...,;ISra rlt City Arlnrne?? SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PR OVISION3. 20 Civic Center Plaza S t A CA 9270 an a na 2 AUTHORIZED REPRESENTATIVE !. ??_ Lv 796$-2070 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD