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Client #:1260332 305ECONOGRO DATE(MMIUDIYYYY)
<br />ACORD. CERTIFICATE OF LIABILITY INSURANCE _ 4122412013
<br />THIS CERTIFICATE IS ISSUED Ai -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 />—1...,.,.,,......,... ---- ........ .__....__..._....__.___. _..., .
<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 Ilea of such ondorsement(s).
<br />BB &T Insurance Services
<br />of Orange County
<br />680 Langsdorf Drive Suite 100
<br />Fullerton, CA 92831
<br />Aegis ITS, Inc.
<br />3360 E. La Palma Ave.
<br />Anaheim, CA 92806
<br />.. _.._...
<br />4VVCRNVGO
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED. NAMEDABOVE FORTHE POLICYPERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 />N R
<br />LTR
<br />TYPE OF INSURANCE_
<br />AOULS
<br />N R
<br />UR
<br />WVD
<br />_ POLICY NUMBER
<br />POt,ICY ELF
<br />fMMIODIYYYYI-
<br />POLICY B %P
<br />MMIDDIYYYY
<br />LIMIT
<br />A
<br />GENERAL LIABILITY
<br />6303193N600TIL13
<br />041271201304127
<br />/201
<br />EACHOCOURRENCE
<br />$1000000
<br />DAMAGE TOEYEN'lEOnce
<br />PMEEEDMEXI'_(Pnyone
<br />3100 DOD
<br />X COMMERCIAL GENERAL LIABILITY
<br />person
<br />$5000
<br />71 CLAIMS -MADE OCCUR
<br />PERSONAL &AOVINJURY
<br />$1L000 ODg
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GEN'LAGOREGATE LIMITAPP_L15S PER:
<br />PRODUCT$ -CbMP /,PAGE
<br />$2,000,000 _-
<br />COMBINED SINGLET
<br />$
<br />$1000,000
<br />A
<br />POMCV PROO LOC
<br />AVTOMOaILF.LIABILITY
<br />8703193N600TIL13
<br />0412712013
<br />04/2712014�epemelt
<br />DODILY INJURY (Per poison)
<br />$
<br />X ANY AUTO
<br />RONLYINJURY(Pereccident)
<br />$
<br />ALL OWNED SOHEOULED
<br />AUT09 .__ AUTOS
<br />X HIRGDAUTOS X AO GOWNED
<br />PROPERTY DAMAGE
<br />-- ""
<br />$
<br />B
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCcuR
<br />100003863002
<br />04/27/2013
<br />041271201
<br />EACH OCCURRENCE
<br />s2,000,000
<br />AGGREGATE
<br />12,000 DDD
<br />EXCESS LIAR_
<br />CLAIMS -MADE
<br />DEU XRETENTION$0`
<br />WORKERS COMPENSATION
<br />--
<br />WC"A"L IOThI-
<br />X __ta
<br />$
<br />_
<br />A
<br />___
<br />U69501609613
<br />_ —___
<br />04/27/2013
<br />0417.71201
<br />EACH
<br />E.L, EACH ACCIDENT__
<br />$1 ODD DOO
<br />ANDEMPLOYERS'IJABILITY
<br />ANY PROPRIETORIPARTNERl-.XECU FIVE YIN
<br />OFFICERIMEMBER EXCLUUDED4
<br />OFFICER
<br />NIA
<br />In NN) -
<br />'[tiP O V�:j �-� A S '-1'x!'4
<br />PARR !A5 S'l.I
<br />FORM
<br />S�MIdb
<br />E,L. UI9EA3E -EA EMPLOYEE
<br />$1000000 —
<br />E.L. DISEASE - POLICY LIMIT
<br />- - - -- --
<br />$1000,000
<br />-- -!- —
<br />Ifnye,d.,ioOeundnr
<br />O ESCRIPTION OF OPBRAT'ION9 below
<br />.i,
<br />�__.
<br />- - - --
<br />.
<br />L
<br />} �tr
<br />/f
<br />LuurExs.,✓�., IV heed
<br />DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES(AIISCB ACORD 'At1',gW frti s',g3ltsAgrp,Lrlylgltf� ore epvice fs required)
<br />Certificate Holder Is added as Additional Insured per poll c orm #CGD2470805 & Waiver of Subrogation
<br />per policy form #CGD4581008 both a part of policy #6303193N60OTI1-13.
<br />Certificate Holder is amended to read: The City, its officers, employees, agents,
<br />volunteers and representatives
<br />RE: Traffic Signal System, Advanced Traffic Management System, and Street Light System Maintenance in and
<br />for the City of Santa Ana,
<br />City of Santa Ana
<br />Attm Vinh Nguyen
<br />P.O. Box 1988 / M043
<br />Santa Ana, CA 92702.1988
<br />SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD CORPORATION. All rinhfs reserved.
<br />ACORD 25 (2010106) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S10366303/M10363110 VLMAL
<br />
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