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_ CERTIFICATE OF LIABILITY INSURANCE
<br />OAT0I20'14 YI
<br />7M4I
<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 pollcy(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 />Aon Risk Services Central, Inc.
<br />Pittsburgh PA Office
<br />CONTACT
<br />NAME:
<br />,.
<br />(AICO.N.EM): (866) 283 -7122 FAX (800) 363 -0105
<br />EMAIL
<br />ADDRESS:
<br />Dominion Tower, 10th Floor
<br />625 Liberty Avenue
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC#
<br />Pittsburgh PA 15222-3110 USA
<br />INSURED
<br />INSURER A: National Union Fire Ins Co of Pittsburgh
<br />19445
<br />RBF ConsUltinq
<br />INSURER B: Liberty Mutual Fire Ins Co
<br />23035
<br />PO BOX 57057
<br />Irvine CA 92619 -7057 USA
<br />INSURER C: Lloyd's Syndicate No. 2623
<br />AA1128623
<br />INSURER D: Liberty Insurance Corporation
<br />42404
<br />INSURER E:
<br />PREMISES Ea occurrence
<br />$1,000,000
<br />INSURER F:
<br />MED EXP (Any one person)
<br />$5,000
<br />COVERAGES CERTIFICATE NUMBER: 570054601504 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 />INSR
<br />TYPE OF INSURANCE
<br />INSD
<br />MD
<br />POLICV'NUMBER
<br />MMIDDIYYYY
<br />MMIODM'YY
<br />LIMITS
<br />•
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />%
<br />9
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<br />EACHOCCURRENCE
<br />$2,000,000
<br />CLAIMS -MADE X❑OCCUR
<br />PREMISES Ea occurrence
<br />$1,000,000
<br />X
<br />MED EXP (Any one person)
<br />$5,000
<br />C0ntraCfcal
<br />X
<br />BFPD, XCU
<br />PERSONAL &ADV INJURY
<br />$2,000,000
<br />GENIAGGREGATE LIMITAPPLIES PER
<br />GENERAL AGGREGATE
<br />$4,000,000
<br />POLICY ❑PRO- ❑X LOC
<br />ECT
<br />APPROVED AS
<br />TO FOR
<br />PRODUCTS - COMP /OPAGG
<br />$4,000,000
<br />OTHER:
<br />•
<br />AUTOMOBILE LIABILITY
<br />A52- 681-00 -724
<br />06/30/201408/30
<br />/2015
<br />COMBINED SINGLE LIMIT
<br />Ea acddent
<br />$1,000,000
<br />X ANY AUTO
<br />BODILY INJURY (Par person)
<br />�`
<br />BODILY INJURY (Par accldenQ
<br />ALL OWNED SCHEDULED
<br />v
<br />A aH
<br />AUTOS AUTOS
<br />NON -OWNED
<br />•..
<br />tAn �ty
<br />Attorney
<br />PROPerewiden=,D)AMAGE
<br />HIRED AUTOS AUTOS
<br />A
<br />X
<br />UMBRELLALIAB
<br />OCCUR
<br />BE018085867
<br />06/30/2013
<br />08/30/2014
<br />EACH OCCURRENCE
<br />$10,000,000
<br />EXCESS LIAR
<br />H
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$10,000,000
<br />LED I X RETENTION 810, 000
<br />D
<br />WORKERS COMPENSATION AND
<br />WA768DO04145694
<br />06/30/2014
<br />08/30/2015
<br />X STATUTE �RH
<br />EMPLOYERS' LIABILITY YIN
<br />AOS
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />D
<br />ANY PROPRIETOR/ PARTNER I EXECUTIVE
<br />WC7681004145704
<br />06/30/2014
<br />08/30/2015
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory in NHI
<br />N/A
<br />WI
<br />EL DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<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 terns
<br />& condi
<br />ions
<br />DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (ACORD 1D1, 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 CANCELLATION
<br />©1966 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (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 />AUTHORIZED REPRESENTATIVE
<br />Attn: Tonia Zerba
<br />20 Civic Center Plaza
<br />PO BOX 1988
<br />%
<br />9
<br />Santa Ana CA 92702 USA
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<br />©1966 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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