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<br />A oRo® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DDIYYYY)
<br />01122/2013
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF IN / TlQ(J ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEG TMEI1Y AMt*, "TEND ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE .k 6ONTAWICT 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. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies.. may require an endorseln$n( '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 />Dominion Tower, 10th Floor
<br />625 Liberty Avenue
<br />CONTACT
<br />NAME'
<br />PHONE (866) 283-7122 FAX (847) 953-5390
<br />(AIC. No. Ext): AIC. No.):
<br />E-MAIL
<br />ADDRESS:
<br />Pittsburgh PA 15222-3110 USA
<br />GENERAL LIABILITY
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURED
<br />RBF Consulting
<br />PO Box 57057
<br />_INSURERA.' Liberty Mutual Fire Ins Co 23035
<br />INSURER B: Liberty Insurance Corporation 42404
<br />INSURER C: Lloyd's Syndicate No. 2623 AA1128623
<br />Irvine CA 92619-7057 USA
<br />INSURER D:
<br />X COMMERCIAL GENERAL LIABILITY
<br />_LL
<br />V J
<br />INSURER E:
<br />INSURER F:
<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 />INSIR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADD
<br />INS
<br />WVD
<br />POLICY NUMBER
<br />(MWDDffYYYI
<br />IMMIDDIYYYY)LIMITS
<br />GENERAL LIABILITY
<br />TB
<br />EACH OCCURRENCE $2,000,000'
<br />X COMMERCIAL GENERAL LIABILITY
<br />DAMAGE TO RENTED
<br />$1,000,000
<br />PREMISES Ea occurrence
<br />CLAIMS -MADE ❑X OCCUR
<br />MED EXP (Any one person) $5,000
<br />X Contractual
<br />PERSONAL & ADV INJURY $2,000,000
<br />X
<br />BFPD, XCU
<br />GENERAL AGGREGATE $4,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG $4,000,000
<br />POLICY FX-] PRO JECT X LOC
<br />A
<br />AUTOMOBILE LIABILITY
<br />AS2-681-004145-722
<br />COMBINED SINGLE LIMIT
<br />Ea accident $1,000,000
<br />BODILY INJURY ( Per person)
<br />x ANY AUTO
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per accident)
<br />AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />X HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />Per accident
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />TH7681004145682
<br />06/30/2012
<br />06/30/2013
<br />EACH OCCURRENCE $10,000,000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />AGGREGATE $10,000,000
<br />DED I RETENTION$10,000
<br />B
<br />WORKERS COMPENSATION AND
<br />wA768DO04145692
<br />06730/2012
<br />06/30/2013
<br />X I WCSTATU- I OTH-
<br />EMPLOYERS' LIABILITY YIN
<br />AOS
<br />TORY LIMITS ER
<br />E.L. EACH ACCIDENT $1,000,000
<br />B
<br />ANYPROPRIETOROFFICER/MEMBER/PARTNER / EXCLUDED?EXECUTIVE
<br />NIA
<br />wc7681004145702
<br />06/30/2012
<br />06/30/2013
<br />E.L. DISEASE -EA EMPLOYEE $1,000,000
<br />(Mandatory in NH)
<br />wI
<br />If yes, describe under
<br />I E.L. DISEASE -POLICY LIMIT $1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />C
<br />E&O-PL-Primary
<br />QC1202675
<br />06/30/2012
<br />06/30/2013
<br />Per Claim $5,000,000
<br />Professional & Pollution
<br />Aggregate $5,000,000
<br />SIR applies per policy terns
<br />& conditions
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Re: Santa Ana Drainage Master Plan. City of Santa Ana, its officers, employees, agents, volunteers and representatives are
<br />included as additional insured on the general liability, but only with respect to work performed by or on behalf of the insured
<br />as required by written contract with the named insured. General liability coverage evidenced herein is primary and
<br />noncontributing to any insurance maintained b,; or for the benefit of the additional insureds. General liability coverage
<br />contains a severability of 41PPRUV EDs iViTO 4PORM
<br />GEKIIFIGAIE MULDER ----CAUCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />-A,SSlstant City AttorneF EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City Of Santa Ana AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza - ROSS Annex (M- )
<br />Santa Ana CA 92701 USA
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />m
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