BLACK & VEATCH CORPORATION 1B - 2014

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ACbRH CERTIFICATE OF LIABILITY INSURANCE 2014 DATE IMM /DD /VVVV) 11/1/2013 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 Lockton Companies, LLC -1 Kansas City 444 W. 47th Street, Suite 900 Kansas City MO 64112 -1906 (816) 960 -9000 CONTACT LIMITS PHONE FAX O Ent : AIC No E-MAIL ADDRESS: Y N GLG4641358 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Conapany 16535 DAMAGE TO RENTED PREMISES (Ea occurrence) INSURED BLACK & VEATCH CORP INSURER B: I INSURER C: 1058332 11401 LAMAR OVERLAND PARK ICS 66211 INSURER D: Bun, Ann INSURER E E4 NSURER F: CLAIMSMAOE OCCUR COVERAGES BLAVE01 CERTIFICATE NUMBER: 11363208 REVISION NUMBER: XXXXXXX 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. I�TR TYPE OF INSURANCE AN R WVD POLICY NUMBER MMIDD POLICY MMIDD/YYYY LIMITS • BENILIABILITY Y N GLG4641358 11/1/2013 11/1/2014 EACH OCCURRENCE , 1„0,�,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 MMERCIAL GENER BILITV MED EXP (Any ane erson $ 10,000 CLAIMSMAOE OCCUR X PERSONAL &ADV INJURY $ 1,000,000 CONTRACTUAL X BFPD & C/0 & XCU GENERAL AGGREGATE $ 1000.000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGO 1000 $ PRO- POLICY PRO- LOC AUTOMOBILE LIABILITY NI N BAP 4641355 (AQS) 11/1/2013 I I/l/2014 COMBI ED SING LIMIT (Ea acmdont) $ 1.000000 X BODILY INJURY (Per person) $ xxxxxX ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X BODILY INJURY Pereccident $ XXXXXXX X X PROPERTY DAMAGE $ XXXXXXX HIRED AUTOS X NON -OWNED HIRED AUTOS N $XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ xxxxxax EXCESS LIAB CLAIMS -MADE DEC RETENTION $ 1 $ XXXXXXX A `a WORKERS COMPENSATION AND EMPLOYERS`LIABILITV YIN ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N NIA N WC 464t353 (AOS) WC 4641354(N MA) 11/1/2013 11/1/2013 11/1/2014 11/1/2014 X C A - TORY LIMITS OTH- ER E. L. EACH ACCIDENT $ 1000000 s E, L. DISEASE - EA EMPLOYEE $ 1000000 (Mandatory in NH) If yes, describe under D ESCRI PTION OF OPERATIONS below E, L. DISEASE - POLICY LIMIT $ 10000 7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if pace is required) PN. 175203; Sanitary Sewer and Water Financial Plan RFP. The City, its officers, empllo s,^t�Lf``g lunteers and re - entatives are included as additional insured on General Liability as required by written contract. 0. `YY..44JJ 103 "O � ^ J (JG J." S C'Gtly PAID rney I "J ant H CERTIFICATE HOLDER r+ CANCELLATION See Attachinents 11363208 City of Santa Ana 220 S. Daisy Avenue, M -85 Santa Ana CA 92703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. / A