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<br />,4`oRa CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/ODNYYY)
<br />912011
<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(ies) must be endorsed. M SUB OGATION IS WAIVED, subject to
<br />the terns 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 Northeast, Inc.
<br />Parsippany NJ Office
<br />CONTACT NAM
<br />P (866) 283 -7122 FAX (847) 953 -5390
<br />(Nc• Ne• Fit :• No.
<br />E-MAIL
<br />ADDRESS:
<br />10 Lanidex Center west
<br />P.O. Box 608
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC e
<br />Parsippany NJ 07054 -0608 USA
<br />INSURED
<br />INSURER A: Zurich American Ins Co
<br />16535
<br />AMEC Geomatrix, Inc.
<br />2101 Webster St., 12th Floor
<br />INSURER a: American Zurich Ins Co
<br />40142
<br />Oakland CA 94612 USA
<br />WSURERC:
<br />INSURER D:
<br />MED EYP (Any one person)
<br />151000
<br />INSURER E:
<br />i
<br />INSURER F:
<br />GUVERAGES GERTIFIGATE NUMBER: b 1UU4Z1tWtu/ 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 />LT TYPE OF INSURANCE
<br />I NDSOR9
<br />yUMO
<br />POLICY NUMBER
<br />POLICY EFF
<br />M
<br />LIMITS
<br />GENERAL LIABILITY
<br />GLO
<br />EACH OCCURRENCE
<br />$1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X� OCCUR
<br />PREMISES R occurrence
<br />S100,000
<br />MED EYP (Any one person)
<br />151000
<br />i
<br />PERSONAL 6 ACV INJURY
<br />$1,000,000
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GENI AGGREGATE LIMIT APPLIES PER!
<br />PRODUCTS - COMP /OP AGG
<br />$2,000,000
<br />POLICY X PRO- X LOC
<br />A
<br />AUTOMOBILE L IABILiry
<br />BAP 3 4 -0
<br />05/01/20110
<br />1
<br />COMBINED SINGLE LIMIT
<br />acx1dontl
<br />$1,000,000
<br />X ANY AUTO
<br />BODILY WJURY ( Per pe,eon)
<br />X ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON -OWNED
<br />X HIRED AUTOS X AUTOS
<br />BODILY INJURY (Per accident)
<br />PROPERTY DAMAGE
<br />Per scLident
<br />X ComplGdl Dad St. '
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />DED RETENTION
<br />B
<br />WORKERS COMPENSATION AND
<br />EMPLOVERS' LIABILITY YIN
<br />ANY PROPRIETOR I PARTNER / EXECUTIVE
<br />OFF RIMEMBER EXCLUDED?
<br />N / A
<br />WC35 4
<br />05/01/20110510112012
<br />WC STATU- DTH-
<br />X TORY LIMITS
<br />E.L. EACH ACCIDENT
<br />Sl, 000 , 000
<br />E.L. DISEASE -EA EMPLOYEE
<br />51, 000 , 000
<br />(Mend
<br />(Mandaseryti NH)
<br />I1 yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />Sl , 000 , 000
<br />A
<br />arch t&Eng Prof
<br />EOC938357 0
<br />Professional /pollution
<br />SIR applies per policy ter
<br />05/01/2 1
<br />s & condi
<br />OS 1/2012
<br />ions
<br />Any One Claim ,000,0 0:
<br />Aggregate S1,000,0001
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AUh h ACORD 101, AddibWnel ReMeWke Sd1edY4, N more spew Is regwmd)
<br />Re: #8586. where required by written contract, The City of Santa Ana, its officers, employees, agents, volunteers and
<br />representatives are included as Additional insureds to General Liability policy and this insurance is Primary and
<br />Non - contributory with any other insurance maintained by the Additional Insureds.
<br />i
<br />APPROVED AS TO FORM
<br />1
<br />CERTIFICATE HOLDER // I , //, CANCELLATION
<br />- ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />Laura St tt Sheedy EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />Assistant City Attor POLICY PROVISIONS.
<br />City of Santa Ana, M -93 AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana CA 92702 USA �/J ,p �,Q �/'►
<br />a34fwaP a7� e.!/I�suEIB! c./l'�` alA(,` �nspL
<br />01988 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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