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ACORD,,, CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY)
<br />3/19/2015 1 10/1/2014
<br />THIS CERTIFICATE IS ISSUED AS A MA17ER 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 policy(les) 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 Lockton Insurance Brokers, LLC
<br />License #OF15767
<br />4275 Executive Square, Suite 600
<br />La Jolla CA 92037
<br />CONTACT
<br />NAME:
<br />rXC,NNIIO, Ext): FAX No
<br />EMAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE NAIC4
<br />(858)587-3100
<br />INSURER A: Valley Forge Insurance Company 20508
<br />N
<br />INSURED IPS Group, Inc.
<br />INSURERS: American Casualty Company of Reading, PA 20427
<br />1377909 5601 Oberlin Drive, Ste. 100
<br />San Diego CA 92121
<br />wsURER C : Continental Casualty Company 20443
<br />CLAIM&MADE x OCCUR
<br />INSURER P'
<br />ENSU E E :
<br />INSURER F :
<br />COVERAGES IPSGROI CERTIFICATE NUMBER: 12813936 REVISION NUMBER: XXXXXXX
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 />INBD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EF'F
<br />MMIDDIYYYY
<br />POLIC ExP
<br />MMIDD
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />Y
<br />N
<br />4034952942
<br />10119/2014
<br />3/19/2015
<br />EACH OCCURRENCE 1,000,000
<br />CLAIM&MADE x OCCUR
<br />PREMISESOEa occurrence 500,000
<br />MED EXP (Any one erson 15,000
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PELT F-1 LOC
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS -COMPlOPAGG $ 2,000,000
<br />$
<br />OTHER
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />N
<br />N
<br />6013847872
<br />10/19/2014
<br />3/19/2015
<br />Ee aoddeDt51NGLE LIMIT $ 1,000,000
<br />BODILY INJURY (Per porion) $ XXXXXXX
<br />ANY AUTO
<br />AUTOS NED AUTOSULED
<br />BODILY INJURY (Per accident $ XXxXXXX
<br />Pe�a.dd..t) GE $ XXXXXXX
<br />X
<br />HIRED AUTOS X AAIOJT 09VV
<br />sXXXXXXX
<br />C
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />N
<br />N
<br />4034952990
<br />10/19/2014
<br />3/19/2015
<br />EACH OCCURRENCE S 5,000,000
<br />AGGREGATE $ 5 000 000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I X I RETENTION $10,000
<br />$ XXXXXXX
<br />1
<br />A
<br />WORKERS COMPENSATIOND E
<br />AND LIABILITY YIN
<br />OFFICERIMEMBER EANYFROPR�ETORIPXCLUDED? ECUTIVE
<br />(Mandatory In NHI
<br />If yes, da.alhe under
<br />DESCRIPTION OF OPERATIONS helm
<br />NIA
<br />N
<br />5093308451 (CA)
<br />5093308496 (AOS)
<br />3/19/2014
<br />3/19/2014
<br />3/19/2015
<br />3/19/2015
<br />PER 'lT11-
<br />X STATUTE
<br />E.L. EACH ACCIDENT $ ooa oao
<br />E.L. DISEASE - EA EMPLOYEE 1,000,000
<br />E.L. DISEASE - POLICY LIMIT 1,000,000
<br />A
<br />Tech E&OINetwork !
<br />Privney / Media
<br />Nl
<br />N
<br />4034952942
<br />10/19/2014
<br />3/19/2015
<br />Each Occ, 5,000,000;
<br />Agg,: 5,000,000;
<br />Ded.: 50,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Re: En�iueering of Parking Meters. The City of Santa Ana, its officers, agents, volunteers, employees and representatives are named as additional insured,
<br />on a primary/non-contributory basis, as respects General Liability per attached. Separation of insureds applies per policy form. 30 day cancellation notice
<br />applies per attached.
<br />[iCl[ I I r hill l C r7 V 6Lir-m
<br />12813936
<br />The Cl" of Santa Ana, its officers, agents,
<br />volunteers, employees and representatives
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />ACORID 25 (20141011
<br />SHOULD ANY OF 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 />© U11114014 ACORD CORPORATION. All Hants reserved
<br />The ACORID name and logo are registered marks of ACORD
<br />
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