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WKEINCO-01 GOMEZB
<br />,a��Rcr CERTIFICATE OF LIABILITY INSURANCE
<br />F° ; 2D°
<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 License # OE67768
<br />IOA Insurance Services -SD
<br />4350 La Jolla Village Drive, Suite 900
<br />San Diego, CA 92122
<br />NAMEAcT Ali Smith
<br />A1C"Ija Eat : (619) 574.6220 AIc No): (619) 574-6288
<br />AoDRESS: Aii.Smith@ioausa.com
<br />INSURERO) AFFORDING COVERAGE NAIC!
<br />INSURERA:RLI Insurance Company 13056
<br />INSURED
<br />WKE, Inc.
<br />400 N. Tustin Ave., #285
<br />Tustin, CA 92705
<br />INSURER e: Atlantic Specialty Insurance Company . 27154
<br />INSURERC:
<br />INSURER o
<br />INSURERE:
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 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.
<br />LTR
<br />TYPE OF INSURANCE
<br />INSR
<br />WVD
<br />POLICY NUMBER
<br />MMOD Y)
<br />(MMOON P LIMBS
<br />,! oil 4 II /
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<br />Ross (M-36)
<br />GENERAL LIABILITY
<br />anta Ana CA92701
<br />EACH OCCURRENCE $ 2,000,006
<br />PpEMISEs Eaoaurtence) $ 1,000,000
<br />A
<br />X COMMERCIALGENERALLIABILITY
<br />X
<br />X
<br />PS80001793
<br />10/11/2013
<br />10/11/2014-
<br />MED EMP (Any one person) $ 10,000
<br />CLAIMS -MADE OOCCUR
<br />X Contractual Liab.
<br />PERSONAL &ADV INXRY $ 2,000,000
<br />X No Co. Owned Autos
<br />GENERAL AGGREGATE $ 4,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS-COMP/OPAGG $ 4,000,000
<br />$
<br />POLICY X '0i LOC
<br />AUTOMOBILE LIABILITY
<br />COMBINED SIN ELIMIT
<br />Ea amidenf $ 2,000,000
<br />BODILY INJURY (Per person) $
<br />A
<br />ANY AUTO
<br />X
<br />PSB0001793
<br />10/11/2013
<br />10/1112014
<br />BODILY INJURY (Per amident) $
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />X HIREDAUTOS X NON -OWNED
<br />AUTOS
<br />PER ACCIDENT $
<br />$
<br />X UMBRELLA LIA6
<br />X
<br />OCCUR
<br />EACH OCCURRENCE $ 2,000,000
<br />AGGREGATE $ 2,000,000
<br />A
<br />excess LMB
<br />cLAIMSMADE
<br />PSE0001694
<br />10/11/2013
<br />10/11/2014
<br />DED I I RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABII
<br />ANY PROPRIETOR/PARTNEMEXECLOIVE YIN
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />NIA
<br />X
<br />PSW0001614
<br />10/11/2013
<br />10/11/2014
<br />X YdC STATU- OTH-
<br />TORY LIMITS ER
<br />E.L. EACHACCIDENT $ 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE $ 1,000,000
<br />If.Yes. describe under
<br />DESCRIPTION OF OPERATIONS below
<br />EL DISEASE -POLICY LIMIT $ 1,000,000
<br />B
<br />Prof Liab/Clms Made
<br />DPL274413
<br />10/11M1311011112014
<br />Per Claim 2,000,000
<br />B
<br />Ded.: $15k Clms Made
<br />DPL274413
<br />10/11/2013
<br />10/11/2014
<br />Aggregate 2,000,000
<br />DESCM"IONOFOPERATIONSILOCATIONSIVEMCLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
<br />Re: Fifth Street Bridge at Santa Ana River
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Additional Insured with respect to General/Hired & Non -Owned Auto
<br />Liability per the attached endorsement as required by written contract. Insurance is Primary and Non -Contributory. Wavier of Subrogation applies to General
<br />Liability and Workers Compensation.
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions.
<br />CERTIFICATE HOLDER /iYY1CV V Yll f1J I") I -)KNI CANCELLATION
<br />ACORD 25 (2010105)
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />' aura Stitt Sheedy
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Santa Ana Assistant City Attorney
<br />AUTHORIZED REPRESENTATIVE
<br />ATTN: Mindy Ly
<br />20 Civic Center Plaza
<br />Annex
<br />,! oil 4 II /
<br />`N
<br />Ross (M-36)
<br />anta Ana CA92701
<br />ACORD 25 (2010105)
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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