CENTURY STRUCTURAL ENGINEERING CO., INC. 3 - 2014

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A��'�� CERTIFICATE OF LIABILITY INSURANCE nATLjMA1ODnYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE / 919/2013 THIS CERTIFICATE 15 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the pOIICy, certain policies may require an entlorsement. A statement on this certificate does not confer rights to the certificate holder In Ileo of such and orsement s . PRODUCER C ACT IMICha�l_I Hall & Com_oanv LjCgD Michael J Hall &Company PHONE FAX A/E Insurance Services erm360-598-3700 INe r N r 3 19680 10th Ave NE eMAli° AooREssoartifi .ateP hallandroIDpanymon Poulsbo WA 98370 INSUREfflB AFFORDING COVERAGE �„- NAIC k INSVRER q; LD C BUal. CO A 25674 INSURED 1273 INsuRERe:UND RWRIT RS AT LOYD LONDOtL16792 Century Structural Engineering Co Inc 24719 Narbonne Avenue INSURERC: - Wsuaeso: LGmlta CA 90717 INSURE E: MED EXP An one arson $5,000 ten. ne-n INSURED P I COV THIS IS TOCERTIFY THAT 7HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FFR 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. ILTR TYPE OF INSURANCE d9 0 POLICY NUMBER M OOY(YEYrr MMIODY EXP LIMITS A GENERAL LIABILITY B804863Le38 /20/2013 120/2014 s1000,COD EAMAGE X COMMERCIALGENERAL LIABILITY DAMAGE10RRENCE Ea c,uttenca ssop,Goo CLAIMS -MADE OCCUR MED EXP An one arson $5,000 X OCP/XCU/BFPO _ PERSONAL &ADV INJURY 51000,000 X Beparatlon lnsds GENERAL AGGREGATE 52,000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOP ASG 82,000000 POLICY X PRO- J,OF LOC S A AUTOMOBILE LIABILITY 6804853LS38 /20/2013 /20/2014 8%,,, 1 E LIMIT 1000,000 ANY AUTO BODILY INJURY (Per ner6onl S ALLOVONED SCHEDULED AUTOS AUTOS BODILY INJURY (Per aceldent) s X X V A TO FOR 1 PeOa ERtlTY IOAMAGE S HIRED A0T0$ AUTNONtlSNNED S UMBRELLA LIAR OCCUR EXCESS LIAR CLAIMSMAUE �n1 YJ� jj EACH OCCURRENCE 5 AGGREGATE § 1 !T OED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIASIUW YIN _. S!!,_. CIt- Icklmp Attorney 8 WC STATU- OTH ANY PROPRIETORWARTNERIFXECUTIVE EACH ACCIDENT § OFFICERIMEMSER EXCLUDED] L1 NIAEL (Mandaloryln NH) f YYe6 RIPTIOe OFO OESGIRIpiION OF OPERATIONS helaw E,L. "Be. Ile EMPLOYE 5 EL DISEASE -PODGY LIMIT S B Pmfenelonal Uab,Clalms Made HPP15841013 /24/2013 112412014 $1.004000 Per Claim 51,004000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLCS IAttseh AGGRO tef, Addllloaol RamaMs Sahetlule, II mma apsoo is requlretl{ f•GmYILI!`A TC lJnl I�cn City of Santa Ana Planning And Building Agency PO BOX 1988 (M-19) Santa Ana CA 92702-1986 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THORIZED REPRESeNTA'nVE �.v.FsrL,011aY-�' . ©1988.2010 ACORD CORPORATION. All rights reserved. ......... 1 ne mi umu name ano Ingo are registered ni of ACORD