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' A/^�'ry �®
<br />��/�` CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDoYYYYI
<br />ov12n915
<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(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 />MARSI4 USA INC.
<br />99HIGH STREET
<br />_
<br />CONTACT
<br />NAM
<br />NAME,
<br />_
<br />PHONE Fax ---
<br />p,.9XUC ___ (Alc No
<br />BOSTON, MA 02110
<br />Alin: beaten &equest@marsh.com I Fax. 212.948.4377
<br />E-MAIL
<br />ADDREsa:,_-,_-„_._-__,____,_,__,___-_,
<br />X
<br />X
<br />INSURERE)AFFORDING COVERAGE NAICN
<br />_ _
<br />INSURER A: National Union Fire Insurance Company 19445
<br />838732-Tel--GA_WUP-15-16 WIESE
<br />INSURED TELi
<br />1390 PICCAENT D LLC
<br />1390 PICCARD CRIME, SUITE 200
<br />INSURER B: New Hampshire Insurance Co. 238Q1
<br />INSURER c: HDbGerllnO America Insurance Company 41343
<br />ROCKVILLE, MD 20850
<br />INSURER D: Illinois National Insurance Company 23017
<br />INSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: NYC -006393499.18 REVISION NUMBER:7
<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 />Lm
<br />OF INSURANCE
<br />ADOLTYPE
<br />9S
<br />POLICY NUMBER
<br />MOLDpYEFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X
<br />X
<br />2362804
<br />011012015
<br />01101/2016
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />- CLAIMS -MADE a OCCUR
<br />DAMAGE TOFRE TD e
<br />$-5.000 000
<br />MEDEXLAnyonepeleon)
<br />$ 5,000
<br />PERSONAL &ADV INJURY
<br />_.
<br />$ 5,000,900
<br />GENERALAGGREGATE
<br />$ 5,000,000
<br />GENL AGGREGATE
<br />LIMIT APPLIES
<br />PER:
<br />PRODUCTS AGO
<br />$ 5,00,000
<br />POLICY
<br />X PRO-
<br />LOC
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />X
<br />3814957 (ADS)
<br />0110112015
<br />01101/2016
<br />E� eBMEeD aINGLC LIMIT
<br />5,000,000
<br />BODILY INJURY (Per parson)
<br />$
<br />BX
<br />ANY AUTO
<br />3814955(MA)
<br />011012015
<br />01101/2016
<br />B
<br />_
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />NON -OWNED
<br />HIREDANI'DS PAUTOS
<br />3814956 (VA)
<br />0111112 015
<br />01101/2016
<br />BODILY INJURY (Par scheme
<br />$
<br />PROPERTY DAMAGE
<br />P2dP.9A44ad—
<br />$ --
<br />PHYSICAL DAMAGE
<br />�...
<br />$ 1,000,000
<br />f,
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />CU011986-03
<br />01101/2015
<br />01101/2016
<br />EACH OCCURRENCE
<br />$ E,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAR
<br />CLAIMS -WOE
<br />DED I I RETENTION;
<br />$
<br />g
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YfN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />REXCLUDEDP N
<br />OFFICERIy In
<br />(Mandetoryin Ntll
<br />NIA
<br />X
<br />011963043 (AOS)
<br />'Adllonel WC/EL policies are shown'
<br />p
<br />011012015
<br />01/0112016
<br />XCSTATU- CTH-
<br />-LIMITS -5,000,000
<br />E. L. EACH ACCIDENT
<br />g
<br />_
<br />E.L. DISEASE -EA EMPLOYE
<br />$ 5,000,000
<br />Byyes,RIMIOe under
<br />OESCRIWION OF OPERATIONS SaIaw
<br />'on the following page'
<br />E.L DISEASE LIMIT
<br />_
<br />$ 5,000,00D
<br />D
<br />PROFESSIONAL
<br />02.306.52.69
<br />011012015
<br />0110112016
<br />_
<br />PEROCCURRENCE 10,000,000
<br />E&O LIABILI rY
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schodula, U more apace is requlretl)
<br />City of Santa Ana, PWA - Transportation &'I radio Engineering Department are Included as additional Insured win respect to General and Auto llaeby, This Insurance is primary and non-conlribWmy over any
<br />existing insurence and limited to liability arising out of the operations of [he named Insured for General Liability and Automobile Liability. WaiverofsubrogRouilsappicable,
<br />J
<br />TELVENT USA, LLC AGREEMENT # A-2013-018 REVIEWED BY:� t✓/ 0. EUNICE HEREDIA (PG. 1 of 8)
<br />CERTIFICATE HOLDER CANCELLATION
<br />Cily of Gants Ana
<br />Attm Vinh Nguyen, P.E., SL CMI Engineer
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />PWA- TraosparteilDS & Tri fIc Engineering
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Sarah A. Stevenson, p
<br />0)1988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />
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