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CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) �.-• -� ` 110/20/2014. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Jerry Noyola. Greyling Insurance Brokerage PHONE (770) 552- 4225 A/0 Nn: 1866)550 -4082 EMAIL er no ola@ Ire lin ADDRE s: 0 x"y � Y y g - com 3780 Mansell Road Suite 370 INSURERIS) AFFORDING COVERAGE NAIC p Alpharetta GA 30022 INSURERA - National Union Eire Ins. Co. 19445 INSURED INSURER B ?somas INSURER C 555 S. Flower Street INSURER D: Suite 4300 INSURER E..: A Los Angeles CA 90071 INSU'RERF. COVERAGES CERTIFICATF NI IMRFR 14 -1b RFVICIn1`J MI IMnro. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE IN SR D POLICY NUMBER MMIDIDIYYYY MMiDDrrYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE. S 1,000,000 X COMMERCIAL GENERAL LIABILITY ...0/15/2.014 DAMAGE TO RENTED PREMISES Eaoccurrenue $ 500,000 A CLAIMS-MADE OCCUR 047634 .../1/2015 MED EXP (Any one person) $ 25,000 PERSONAL & ADV INJURY $ 1,000,0010 X Contractual Liaba.la.t GENERAL. AGGREGATE '''.$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER :. PRODUCTS - COMPIOPAGG S 2,000,000 POLICY X PRO- X... LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident) ' $ 1,000,000 A X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS '.AUTOS 814893 10/15/2014 /1/2015 BODILY INJURY (Per accidenl) S X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIM'S -MADE AGGREGATE S.... DID RITENTICN$ '.......$ A WORKERS COMPENSATION .26034794 (AOS) 10/15/2014 ,11/2015 X WC STATU- OTH- , LIMITS ER AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT $ 1,00 0 OOO ANY PROPRIETOPYPARTNERIEXECUTIVE NIA A QFFICEWa49EMBER EXGLUGED? (Mandatory in NH) 026034733 (CA) 0/15/2014 /1/2D15 E.L. DISEASE - EA EMPLOYE. $ 1 000 000 It yes, describe under E.L. DISEASE - POLICY LIMIT $ 1 000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101„ Additional Remarks Schedule, if more space Is required) Re., 2SAN410111; Walnut Pump Station Upgrade Project. The City of Santa Ana, its officers, employees, agents, volunteers & representatives are named as Additional Insureds with respects to General Liability where required by written contract. The above referenced liability policies are primary &. non- contributory where required by written contract. Separation of Insureds applies to the General Liability Policy'. Waiver of Subrogation is applicable where required by written contract & allowed by law. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days, written notice (except 10 days for nonpayment of premium) will be provided to the City of Santa Ana Rudy Rosas 220 S. Daisy Avenue, M -85 Santa Ana, CA 92703 Lei;1►LJOJ'RIIIIW =1 tl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Collings/JERRY 'I -n4 �w� AGUKU 25 (2010/05) 071988 -2010 ACORD CORPORATION. All rights reserved. INS0215 r7mnn:sl ni 'rkn ACnpn n�mc anri Innn nro mnictararl mnrlee of Ar'rt.pn