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A °® CERTIFICATE OF LIABILITY INSURANCE
<br />°AT 07/31204""'
<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 [Tan 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 endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />ADD Risk Services Central, Inc.
<br />Pittsburgh PA office
<br />CONTACT
<br />PHONE ) (g66) 283 -7122 FAX No.): (800) 363 -0105
<br />(AIC. Nc.EXt:
<br />Dominion Tower, 10th Floor
<br />625 Liberty Avenue
<br />E -MAIL
<br />ADDRESS:
<br />Pittsburgh PA 15222 -3110 USA
<br />TB 1 4145714
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURED
<br />INSURER A: National union Fire IDs Co of Pittsburgh
<br />19445
<br />RBF Consultin0
<br />PO Box 57057
<br />Irvine CA 92619 -7057 USA
<br />INSURER B: Liberty Mutual Fire Ins Co
<br />23035
<br />INSURER C: Lloyds Syndicate No. 2623
<br />AA1128623
<br />INSURER D: Liberty Insurance Corporation
<br />42404
<br />DAMAGETO R
<br />PREMISES En occurrence
<br />$1,000,000
<br />INSURER E:
<br />MED EXP(Any one person)
<br />INSURER F:
<br />Contractual
<br />COVERAGES CERTIFICATE NUMBER: 570054495406 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. Limits shown are as requested
<br />R
<br />ILTR
<br />TYPE OF INSURANCE
<br />ADD[
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY ID EFF
<br />MMIDDIYYYY
<br />P L Y
<br />MMIDDM/YY
<br />LIMITS
<br />B
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />TB 1 4145714
<br />15
<br />EACH OCCURRENCE
<br />$2,000,000
<br />CLAIMS -MADE ❑X OCCUR
<br />DAMAGETO R
<br />PREMISES En occurrence
<br />$1,000,000
<br />X
<br />MED EXP(Any one person)
<br />$5,000
<br />Contractual
<br />X
<br />PEPE, XCU
<br />PERSONAL &ADA INJURY
<br />$2,000,000
<br />T ®FO
<br />M
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />GEN ERAL AGGREGATE
<br />$4,000,000
<br />O -
<br />POLICY ❑ PRJECT X LOC
<br />T,
<br />PRODUCTS- COMPIOP AGG
<br />$4,000,000
<br />OTHER'.
<br />B
<br />AUTOMOBILE LIABILITY
<br />A52 -681 -0 1 5- 4
<br />06/30/201408/30
<br />(
<br />/2015
<br />COMBINED SINGLE LIMIT
<br />En accident
<br />$1,000,000
<br />X ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS NON -OWNED
<br />AUTOS
<br />N
<br />A t9nt
<br />6 ®UV
<br />A/V
<br />y AtIIii
<br />BODILY INJURY( Per person)
<br />B0DILYINJURY(Parac -.0)
<br />PROPERTY DAMAGE
<br />Per accident
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />BE018085867
<br />06/30/2013
<br />08/30 /2014
<br />EACH OCCURRENCE
<br />$10,000,000
<br />EXCESS LIAB
<br />CLAIMS-MADE
<br />AGGREGATE
<br />$10,000,000
<br />DEO
<br />I X
<br />RETENTION $10,000
<br />D
<br />D
<br />WORKERS COMPEN A ION AND YIN
<br />ANYPROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? F9
<br />NIA
<br />WA768DO04145694
<br />WC7681004145704
<br />06/30/2014
<br />06/30/2014
<br />08/30/2015
<br />08/30/201$
<br />X STATUTE OTH-
<br />EL EACH ACCIDENT
<br />$1,000,006
<br />E. L. DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory In NH)
<br />If
<br />DESCRIPTION OF OPERATIONS below
<br />WI
<br />-
<br />E. L. DISEASE POLICY LIMIT
<br />$1,000,000
<br />C
<br />E&O -PL- Primary
<br />QC1402675
<br />06/30/2014
<br />08/31/2015
<br />Per Claim
<br />$5,000,000
<br />Professional & Pollution
<br />Aggregate
<br />$5,000,000
<br />SIR applies per policy ter
<br />is & condi
<br />ions
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: Environmental Services and Technical Studies. City of Santa Ana, its officers, agents, volunteers, employees and
<br />representatives are Additional Insured as respects to General Liability as required by written contract.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />01988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE
<br />DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City of Santa Ana
<br />Attn: Tonia Zerba
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />PO Box 1988
<br />Santa Ana CA. 92702 USA
<br />01988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD
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