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Acid CERTIFICATE OF LIABILITY INSURANCE
<br />1 7/15/2014
<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 policy(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 endorsemen4 s .
<br />PRODUCER
<br />Alllanf Insurance Services, Inc.
<br />333 Earle Ovington Blvd.
<br />Suite 700
<br />Suite
<br />CAN�ACT Forward All Certificate Revision Requests to
<br />PHONE,the Below E -Mail FAX
<br />EM . NorthStarGroupServices@allianCcom
<br />INSURERJE AFFORDING COVERAGE RAID
<br />Uniondale NY 11553
<br />INSURERA:National Union Fire Ins Cc Pittsbur 19445
<br />OL5388321 ((AOS)
<br />GL5388322 (NY)
<br />INSURED
<br />INSURER B:NeW Hampshire Insurance Company 23841
<br />NorthStar Demolition and Remediation, LP
<br />like NCM Demolition and Remediation, LP
<br />404 North Berry Street
<br />INSURER C;AIG Specialty Insurance Company 26883
<br />INSURER o:AGCS Marine Insurance Company 22837
<br />INSURER E:
<br />Brea CA 92821-3104
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER' 1854235647 RFVISIQfJ NIIMRFR-
<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 REOUIREMENT, 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 />MSR
<br />LTR
<br />TYPE OF INSURANCE
<br />O DLSUSR
<br />?NSD
<br />WVD
<br />POLICY NUMBER
<br />POUCYEFF
<br />MOO ri
<br />POLICY EXP
<br />OD YY
<br />LIMITS
<br />A
<br />A
<br />X COMMERCIALOENERALLIABILITY
<br />CLAIMS -MADE LI OCCUR
<br />Y
<br />Y
<br />OL5388321 ((AOS)
<br />GL5388322 (NY)
<br />/112014
<br />/1/2014
<br />7/1/2015
<br />7/1/2015
<br />EACHOCCURRENCE $21OD0,000
<br />DAMAGE TO RENTED
<br />PREMISES -a oc nce $300,000
<br />MED EXP (Any one person) $25,000
<br />PERSONAL& ADV INJURY $2,000,000
<br />GEN'L AGGREGATE LIM IT APPLIES PER',
<br />POLICY JEO LOC
<br />GENERAL AGGREGATE $4,000.,000
<br />PRODUCTS-COMP/OP AIG $4,000,000
<br />$
<br />OTHER:
<br />A
<br />A
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />ALLOWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS X NON OWNED
<br />AUTOS
<br />Y
<br />Y
<br />CA5101686 AOS
<br />CA5101887 MA)
<br />CA5101S88 VA)
<br />/1/2014
<br />H/2014
<br />/1/2014
<br />7/1/2015
<br />7/112015
<br />7/112015
<br />'" $
<br />Ea eccitlent 1,000,000
<br />BODILY INJURY (Per person $
<br />)
<br />BODILY INJURY Perecdtlent $
<br />( )
<br />DA GE $
<br />Per accitlent
<br />A
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />BE018947081
<br />/1/2014
<br />7/1/2015
<br />EACH OCCURRENCE $15,000,000
<br />AGGREGATE $15,000,000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DEP X RETENTION$10,000
<br />$
<br />B
<br />B
<br />B
<br />B
<br />B
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? FN
<br />Ugs.dtory In NH)e.und
<br />Il ves,deeTIONunder
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />Y
<br />WC34157313 AOS)
<br />WC34157314 CA)
<br />WC34157316 ADS)
<br />WC34157316 IL,KY,NC,VT)
<br />WC34157318((GAVA)
<br />WC34167319 (CA)
<br />/112014
<br />/112014
<br />/1/2014
<br />/1/2014
<br />/1/2014
<br />/112014
<br />7/1/2015
<br />7/1/2015
<br />7/1/2015
<br />7/1/2015
<br />7/1/2015
<br />7/1/2015
<br />% PTAT TE EPH
<br />E.L. EACH ACCIDENT $1,OOD,000
<br />E.L. DISEAASE—EA EMPLOYE $1,003,000
<br />E.L. DIBEASE- POLICY LIMIT $1,000,000
<br />B
<br />C
<br />D
<br />Workers Compensation
<br />Poll/Prof lnd.MCld/Fungus/Asbest
<br />LeasedlRented Equipment
<br />Y
<br />y
<br />y
<br />Y
<br />y
<br />y
<br />WC34157320(FL)
<br />COPS37006799
<br />MX193059357
<br />/112014
<br />71112014
<br />/112014
<br />7/1/2015
<br />7/112015
<br />7/112015
<br />$1,000,000
<br />$10,000,OOD
<br />$1,500,300
<br />DESCRIPTION OF OPERATIONS I LOCATIONS" VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached II mere apace 1¢ mqulradl
<br />RE: On -Call Demolition Services.
<br />City of Santa Ana is included as Additional Insured on a Primary and Non -Contributory basis as respects General Liability, Automobile
<br />Liability, and Umbrella Liability as required by written contract. Waiver of Subrogation is included and applies In favor of the Additional
<br />Insured as required by written contract.
<br />IFIFIDnXIVIA A 0�l Fn
<br />City of Santa Ana �RckL(aura A.
<br />20 Civic Ceigr j iggaKA�.�
<br />Santa Ana CA 92702-
<br />ey
<br />F1r111:16yC1�11[eG
<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 />U 1IRW-ZU14 AGUKU UUKVUKAI IUN. All rlgnts reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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