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ACORD®CERTIFICATE OF LIABILITY INSURANCE D Y, 5/24//24/ 2013013 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 Grayling Insurance Brokerage 450 Northridge Parkway Suite 102 Atlanta GA 30350 IC'ONTACT Jerry Noycla ��p PHONE 1. (770) 5 52-4225 INCN (866)550-4082 ADDRESS: 3erry.noyola@greyling.com INSURERIS) AFFORDING COVERAGE NAE IT INSURERA National Union Fire Ins Co 19445 _ INSURED POWER Engineers, Inc. 3940 Glenbrook Drive P.O. BOX 1066 iHailey ID 83333 INSURER IS New Hampshire Insurance Company 3841 INS.MERc:S ndicat. 2623/623 at Lloyd's INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:13-14 (PEI) REVISION NUMBER: 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. INSR1ITH RHER TYPE OF INSURANCE AODL'.SU D POLICY NUMBER POLICY EYY MM:'MDCY EXP LIMITS AUTHORIZED REPRESENTATIVE GENERAL LIABILITY '1. M-36 ( uta Stud S11L EACHOCCURFENCE IIS 1,000,000 Santa Ana, CA 92701 OMMERCIAL GENERAL LIABILITY I PREMLSE I E. S 500,000 ACLAIMS,MAOEOCCUR tI.ntractual L 5094741 6/1/2013 4/1/2014 MED EXP(My one person l 5 25,000 PERSONAL& ADV INJURY S 3,000,000 Liability GENERAL AGGREGATE 5 2,000,000 GENT AGGREGATE LIMIT APPLIES PEN:.PRODUCTS-COMPIOPAC,C S 2,000,000 $ POLICY x PR0. X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1y000 000 'Ea aoe4 Jl_____ BODILY INJURY ver person) $ R ANY AUTO A ALL. OWNED SCHEDULED 2A 6403759 (AOS) 6/1/20134/1,12014 BODILY INJURYT. a[ciJenl) S A R AUTOS . x NONOWNED A 6403760 (MA) 6/1/2013 /1/2014 PROPERTY DAMAGE 3 iP L nU nl HIREDAUTOS AUTOS S UMBRELLA LIAR OCCUREACH OCCURRENCE S AGGREGATE 3 EXCESS LIAR CLAIMS -MADE DED I I RETEITIONUL S B WORKERS COMPENSATION 4C 049901174 (AOS) /1/2013 '4/1/2014 R WC STATU OTRH AND EMPLOYERS' LIABILITY -- ANY PROPRIETOR)PARTNEREXEGLTV6r; EL. EACH ACCIDENT 5 1 OOO OOO A OFFlOEWh1MBER EXCLUDED? I J MIT) ( Ory In NIA C 04990117(MA) 6/1/2013 4/1/2014 ELDISEASE._YE S i 000 000 _E.A_Lb_PL_O_ E L. DISEASE POLICY LIMIT 5 1 000 D00 tKes,d ambaundeu DSRPPTION OF OPERATIONS tlelav C Professional Liability 913B97130101 6/1/2913 _ 4/1/2014 Par Claim $5,000,000 Ample $5,000,000 DESCRIPTION OF OPERATIONS [LOCATIONS ! VEHICILE5 Adlach ACORD 101, Additional Rcil Schedule, if more space Is required) The City of Santa Ana, its officers, employees, agents, volunteers & representatives are named as Additional Insureds on the above referenced liability policies with the exception of workers compensation S professional liability where required by written contract. The above referenced liability policies with the exception of professional liability are primary 6 non-contributory where required by written contract. waiver of Subrogation is applicable where required by written contract 5 allowed by law. Separation of Insureds applies to the General Liability Policy. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, we will endeavor to CFRTIFICATF HDI nFR CANCELLATION ACORD 25 (2010/05) ©1988.2010 ACORD CORPORATION. All rights reserved. INsms ion,nn;, p. Th. Arnran namo PmA Inns a.a mniemro.i mark. of ArnRn SHEO,U�L ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE F�S-OT'/�' /1- j?) 7D{ A�JCt7�DVS�'CEIWTHON DTHEEPOLICY PROVISONISE WILL BE DELIVERED IN City of Santa Ana _ BU21 FUrj anlC AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza 11,_ s M-36 ( uta Stud S11L r}' Santa Ana, CA 92701 ,1a>Itit tni li[y A[U: 6aTApd Collings/JERK? ACORD 25 (2010/05) ©1988.2010 ACORD CORPORATION. All rights reserved. INsms ion,nn;, p. Th. Arnran namo PmA Inns a.a mniemro.i mark. of ArnRn