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R ��ar,t <br />""�, "'" CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MNUDD/YYYY) <br />TV PE OF INSURANCE <br />06/20/2012 <br />THfS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />POLICY NUMBER <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BV THE POLICIES <br />M V EX <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 6�TV�{N THE ISSUING INSURER(S), AUTHORIZED <br />A <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE E{�t 1r _'L �� j= V "I <br />IMPORTANT: If tFla carlifi®ta hdder ie an ADDITONAL INSURE pofiey(ias) must Ua endorsed. If SUBROGATION IS WAIVED, subject tD <br />GL885879 <br />the tense and conditions of the policy, certain polities may require an endorsement A 9tatornantepf.t)I�certiFtate does not confer rights to the <br />certificate holder in lieu of such endorolsmaM(s). r, � -�- �- -, } " ` <br />Di/Oif2Di3 <br />PRODUCER .. <br />Orion Risk Management Insurance Services,``Inc. <br />Ca. Lic. #OD28764 <br />9 <br />2280 Wardlow Circle, Sui #e 250 N�O�aO� -�6� <br />�NAMI � <br />PCNE Ert,951.736.9477 F.v�G No,951.736.9478 <br />- L <br />ADDRESS: <br />MED EXP (Any one peracn) <br />DuceR 00001183 <br />PERSONALBADVINJVRY <br />- <br />Corona, CA 92880 <br />INSURER AFFORDMO OOVER/►DE <br />NAlci <br />INSURED <br />Select Trenchless Pipelines, Inc. <br />DBA: Rooter Alert <br />283 Ilfinfieid Circle <br />Corona, CA 92880 <br />NSVRERA: GO en Eag a Insurance Corp. <br />10836 <br />wsuReRa: Nationwide Ins. Co. <br />25453 <br />wsuRERC: <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OW NED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUT03 <br />NON -0WNED AUTOS <br />wsuRERD: <br />'`. i' <br />ACPBA780503882 <br />T� <br />ii' SZ. {_� UY -`-,Li F,� TQ y' <br />____ __ <br />1NSVRER E <br />08/i4120i3 <br />INSURFJ0. F <br />S 1 ODO Q <br />X <br />BODILY PIJVRY (Per person) <br />COVERAGES CERTIFICATE NUMBER: 12/I3 GL /Auto 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 />ILTR <br />TV PE OF INSURANCE <br />IN9R <br />NND <br />POLICY NUMBER <br />��FFP <br />M V EX <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENEruL LIABILITY <br />CLAIMSaYIADE � OCCUR <br />GL885879 <br />D7l01 /2Di2 <br />Di/Oif2Di3 <br />EACH OCCURRENCE <br />f 1, DOD, 00 <br />T RE <br />S SD OO <br />MED EXP (Any one peracn) <br />E l0 <br />PERSONALBADVINJVRY <br />S 1 OOO,O <br />GENERAL AGGREGATE <br />S 2 ,GOO, <br />GFJJ'L AGGREGATE LIMIT APPLIES PER: <br />POLICY X jEro- LOC <br />PRODUCTS - COMP/OP AGG <br />s 2 (IAA OO <br />S <br />B <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OW NED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUT03 <br />NON -0WNED AUTOS <br />'`. i' <br />ACPBA780503882 <br />T� <br />ii' SZ. {_� UY -`-,Li F,� TQ y' <br />____ __ <br />06174f20i2 <br />kti, ; . <br />08/i4120i3 <br />(DMBINED SINGLE LIMIT <br />FA accident <br />S 1 ODO Q <br />X <br />BODILY PIJVRY (Per person) <br />S <br />BODILY WJVRY (Par LOCidani) <br />S <br />(Pe�e� ryDAMAGE <br />S <br />S <br />s <br />UMBRELLA LIAR <br />E]tCESS LIAB <br />OCCUR <br />CLAIMS�r1ADE <br />-.:1 V <br />2V��'• F:lk1Y1 � � i t �1 '� t Oin c" <br />_ _ _- � � •` <br />I I '�• ���. ~"'"•" � � /�� <br />1 :.� <br />EACH OCCVRRENCE <br />S' <br />AGGREGATE <br />S <br />DEDUCTIBLE <br />RETENTION s <br />: <br />.4 <br />WORRER9 GONPENSAT/DN <br />AND EMPLOYERS' LIABILITY y / N <br />ANY PROPRIETOR/PARTNER/EXECUTNE <br />OFFICERlMEMBER EXCLUDED? O <br />(Mandatory In NH) <br />1/ deavibe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />rt++`` - - ' � : 4 + • <br />L ` �- � M1• ° "' <br />- <br />E.L. EACH ACCIDENT <br />E <br />E.L. DISEASE -EA EMPLOYEE <br />S <br />E.L. DISEASE - POLICY LIMrr <br />$ <br />DESCRIPTION OF OPERATON91 LOCATIONS / VEHICLES IAt/seh ACORD 101, AtldlBOrrel Renrarlra Schedule, 1/ mere spaq b regWred) <br />he City of Santa Ana, its officers, agents, volunteers, and employees are named as additional <br />nsured per the terms and conditions of the attached endorsement_ Primary wording applies per the terms <br />f the attached endorsement_ <br />\iCR r rrr \aI1 r C FIVLVCR VA1rV CLAMI RiPa <br />SHOULD ANY OF THE A80VE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE MALL BE DEI..IYERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />c; ty of Santa Ana AUTHORIZED REPReacNTATVE <br />20 Civic Center Plaza �M -30� � �A� <br />P_O_ Box 1988 <br />Sa to Ana, CA 92702 -1988 La cite Del Pozo UD <br />®'1988 -2009 ACORD CORPORATION. All rights reserved. <br />ACORO 2S (2009/09) The ACORD name and logo are registered marks Of ACORD <br />