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�`� V CERTIFICATE OF LIABILITY INSURANCE
<br />O08 /30ID0WI3 )
<br />08/30/2013
<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 pollcy(ies) 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 1- 000- 000 -0000
<br />Marsh Risk and Insurance Services
<br />CONTACT
<br />NAME:
<br />AI�N o xt: 888- 769 -3873 FAX No:
<br />AMAIL
<br />ADDRESS:
<br />345 California Street
<br />Suite 1300
<br />San Francisco, CA 94104
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A: NATIONAL UNION FIRE INS CO OF PITTS
<br />19445
<br />INSURED
<br />INSURER B: ZURICH AMER INS CO
<br />16535
<br />TUBE Corporation
<br />dba URS Corporation Americas
<br />INSURER C: SEE ATTACHED
<br />INSURER D: Lloyd's of London & British Companies
<br />$ 1,000,000
<br />2020 E. First Street, Suite 400
<br />INSURER E: LEXINGTON INS CO
<br />19437
<br />Santa Ana, CA 92705
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 35478947 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUER
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />GL 5142592
<br />09/01/1
<br />09/01/14
<br />EACH OCCURRENCE
<br />$2,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />DAMA ET RENTED
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />MED EXP(Any one person)
<br />$ 10,000
<br />• XCU, HFPD
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />•
<br />Contractual Liability
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS AGG
<br />$2,000,000
<br />$
<br />POLICY X JPEp LOC
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />13AP938521504
<br />09/01/12
<br />09/01/14
<br />COMBINED ISINGLE LIMIT
<br />2,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per accident)
<br />$
<br />AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />LED I RETENTION$
<br />$
<br />L.
<br />WORKERS COMPENSATION
<br />SEE ATTACHED
<br />01/01/1
<br />01/01/14
<br />X WC STATU- OTH
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNEWEXECUTIVE
<br />E.L. EACH ACCIDENT
<br />$ 2,000,000
<br />OFFICERIMEMBER EXCLUDED7 NN
<br />NIA
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 2,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 2,000,000
<br />D
<br />ClaimsMade Retro 11 -17 -38
<br />PP1307135
<br />09/01/1
<br />09/01/14
<br />E
<br />Prof Liab w /Lmtd Contract
<br />015438088
<br />09/01/1
<br />09/01/14
<br />Each Claim / ASH
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACO RD 101, Additional Remarks Schedule, if more space Is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional
<br />Insureds as respects the General Liability policy, where required by written contract. This insurance is Primary over
<br />any similar insurance available to any person or organization we have added to this policy as Additional Insureds.
<br />APPROVE'D AS TO FORM
<br />CERTIFICATE HOLDER '�.,...✓".- _ / , . e,,.. --- -CANCELLATION
<br />ACORD 25 (2010105)
<br />EHuckabeeURS
<br />35478947
<br />© 1988 -2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />�~ R. our I' 1 If ShOCL {y
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana A,SSASta `�i }V Attorney
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />a
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza - Ross Annex (M -36)
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701F+�a—
<br />USA
<br />ACORD 25 (2010105)
<br />EHuckabeeURS
<br />35478947
<br />© 1988 -2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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