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CERTIFICATE OF LIABILITY INSURANCE
<br />OATE(MM / °DYY
<br />08/11/2014
<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($), 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 endarsement(s).
<br />PRODUCER
<br />AOn Risk services Northeast, Inc.
<br />Ann Risk Services Northeast, Inc.
<br />CONTACT
<br />AUTHOR2EO REPRCSENTATWE
<br />PHONE
<br />(MO.
<br />866-$83 -71i$ FAY` 800- 363 -0105
<br />NO. EM): NO.:
<br />NY NY Office
<br />199 water Street
<br />E-MML
<br />ADDRESS:
<br />New York NY 10038 -3551 USA
<br />4
<br />EACH OCCURRENCE
<br />INSURER(S)AFFORDING COVERAGE
<br />NAIL#
<br />INSURED
<br />INSURERA: AXA Insurance Company
<br />33022
<br />Bureau Veritas North America, Inc.
<br />1665 scenic Avenue, Ste. 200
<br />Costa Mesa CA 92626 USA
<br />_
<br />INSURER 6: New Hampshire Ins Co
<br />23841
<br />-..
<br />INSURERC: National union Fire ins cc of Pittsburgh
<br />19445
<br />INSURER D: The Insurance Cc of the State of PA
<br />19429
<br />INaURERE: Granite State Insurance company
<br />23809
<br />PERSONAL &ADV INJURY
<br />INSURER F.
<br />Uuvtf AUn= UtKI II- IUA It NUMtltK: Of UUbb 1 U4W'd REVISION NUMBER:
<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 REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCWSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />TYPEOFINSURANCE
<br />INS;
<br />WAD
<br />POLICYNUMBER
<br />M
<br />POLICYPROVISIONS.
<br />DYE
<br />LIMITS
<br />AUTHOR2EO REPRCSENTATWE
<br />X
<br />COMMERCIALGENERALLMBNtt
<br />CLAIMG'1MDE XX OCCUR
<br />QS /4TH,
<br />L
<br />4
<br />EACH OCCURRENCE
<br />$1,000,000
<br />G
<br />PREMISES c.Tenne
<br />$1,000,000
<br />MEC,EXP Any one person)
<br />$25,000
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />GENLAGGREGATE UMITAPPLIES PER:
<br />PR0.
<br />POUOY X JECT X Lac
<br />GENERALAGGREGATE
<br />$2,000,000
<br />PRODUCTS - COMP /OPAGG
<br />$2,000,000
<br />OTHER:
<br />O
<br />AUTOMOBILE LMBILITY
<br />CA 7030195
<br />ADS
<br />04/01/2014
<br />01/01/2015
<br />COMBINED SINGLE LIMIT
<br />Ee salaam
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />E
<br />X ANYAUTO
<br />CA 7030196
<br />04/01/2014
<br />01/01/2015
<br />ALLOWNEO SCHEDULE)
<br />AUTOS AUTDB
<br />HIREDAUTOS NON•OWN -ED
<br />AUTOS
<br />MA
<br />BODILY INJURY(PeracdEen)
<br />PROPERttOAMFlGE
<br />Perecddenl
<br />UMBREDALMB
<br />OCCUR
<br />EACH OCCURRENCE
<br />"cams WAS
<br />CLAIMS,MAOE
<br />AGGREGATE
<br />113501
<br />RETENTION
<br />B
<br />BANYPROPRIETOR
<br />WOMERSCOMPENScHONAND
<br />EMPLOYERS' LMBRJTY YIN
<br />I PARTNER) EXECUTIVE
<br />OFHCEPoM5v8ER ERCLUDEDi
<br />(Myyantletmy In NH)
<br />OEB�RIPTION OF OPERATIONS below
<br />N/A
<br />WC01 56 200
<br />ADS
<br />wC013566201
<br />NJ, PA
<br />04/01/2014
<br />pl /01/2015
<br />X PER STATUTE 1 011.
<br />ER
<br />EL EACHACCIDENT
<br />$1,000,000
<br />ELDISEASE- FAEMPLOYEE
<br />$1,000,000
<br />EL. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />A
<br />Arehit &Eng Prof
<br />PCSCG188414
<br />SIR applies per policy ter
<br />01/01/2OL4
<br />is & condf
<br />01/01/2015
<br />ions
<br />each Claim
<br />Each Aggregate
<br />$1,000,000
<br />$1,000,000
<br />DESCRIPTION OF GPEMnDNS /LOCATIONS /VEHICLES (ACORD 101, AtltlRlonal Remarks ScheaWe, maybe attached IP mare spaceis required)
<br />RE: (ENS) Program Management; 2509.14.276R1.
<br />City of Santa Ana its officers, employees, agents, volunteers and representatives are included as Additional insured in
<br />accordance with tine policy provisions of the General Liabi7lt policy. General Liability evidenced herein is Primary and
<br />Non - contributory to other insuranc ®available to an Additional insured, but only in accordance with the policy's provisions.
<br />separation of insureds is included 7Mattorddnce with the policy provisions of the General Liability policy. The Architects &
<br />Engineers policy includes coverage fo Professional Liability and Contractors Pollution Liability.
<br />CERTIFICATE HOLDER CANCELLATION
<br />@1988-2014 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2014/01) The A d r gistered marks of ACORD
<br />Cp
<br />�y
<br />Q�r 'J it
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE- THEREOF, NOTICE WILL OE DUIJVEREM IN ACGORDANCE WITH THE
<br />'C
<br />POLICYPROVISIONS.
<br />City Of Santa Ana
<br />Clerk of the City Council
<br />AUTHOR2EO REPRCSENTATWE
<br />20 Civic Center Plaza (M -3
<br />Santa Ana CA 92702 -1988 uS�
<br />QS /4TH,
<br />A
<br />'�T�O e1Ye'yy �f,e7 e/i` ,f
<br />@1988-2014 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2014/01) The A d r gistered marks of ACORD
<br />Cp
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<br />Q�r 'J it
<br />
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