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A►CQRU CERTIFICATE OF LIABILITY INSURANCE F DATsl18/20�YY)
<br />15
<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(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 />PRODUCERCON 'A. T
<br />flsk Strat'G IGS Company NAME: Risk Strategies Com any
<br />2940 Main Street, Suite 450 PHCYNE rC kI 949-242-9240 FAX 9240
<br />Irvine, CA 92614 _._.....-
<br />E-MAIL e - .._m.._.....
<br />INSURER(Si AFFORDING COVERAGE _NAIC 9
<br />wvvw risk strategies.com CA DOI License No. OF06675 INSURER A: Citizens Insurance Co, of America .� ._._ 31534
<br />INSURED INSURER B : Allmerlca Financial Benefit Ins 'Co-._.... 41840 .�.
<br />T & B Planning Inc.
<br />17542 , 17th treet, Suite 1917 INSURER C : Hanover American Insurance Co.... __..._T 36664
<br />Tustin CA 92789 INSURER D: Confinental Casualty Company.__........__..___ 20443
<br />INSURER, E:
<br />''..... INSURER.. F:
<br />rf)VrPAr.FC r1=PTIPtr ATF NIIN9Rr-P- ')AA7511'3n RFyusinN Ntimiar-R.
<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 CONTRACT OR OTHER DOCUMENT W4TH 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 />�.-_..... ADDL SUBR POLICY EFF POLICY EX ..m. ---_
<br />INSR TYPE OF INSURANCE. LIMITS
<br />LTR POLICY NUMBER MM1DDfYYYY MMfODIYYYY
<br />A
<br />".✓
<br />COMMERCIAL GENERAL LIABILITY
<br />✓
<br />''.083A546792
<br />2/1/2015
<br />21112016
<br />EACH OCCURRENCE S $2,000,000
<br />���
<br />CLAIMS -MADE I V I OCCUR
<br />.,[)AP!'iAGE TORN
<br />O RENTED
<br />PREMIS.ES{Eaoccurrence S $1,000,000
<br />MED EXP (Ary one person) S $10,000
<br />__
<br />..
<br />PERSONALBADV INJURY $ $2,000,000
<br />GFN'L AGGREGATE LIMIT APPLIES PER,
<br />GENERAL AGGREGATE $ $4,000,000
<br />POLICY lu, ECT Lac
<br />J
<br />PRODUCTS-COMP/OPAGG $ $4,000,000
<br />S
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />AW3A212497
<br />2/1/2015
<br />2/1/2016
<br />(O MBINEenDlSINGLE LIMIT � _$1,000,000
<br />INJURY (Per person) S
<br />f ANY AUTO
<br />,BODILY
<br />BODILY INJURY (Per accident) S
<br />_. OWNED SCHEDULED
<br />ALL OWAUTOS AUTOS
<br />NON -OWNED
<br />HIREDAUTOS, AUTOS
<br />PROPEFiTYDAMAGE S
<br />Per accident
<br />A
<br />UMBRELLA LIAR
<br />OCCUR
<br />OB3A546792
<br />2/112015
<br />2/112016
<br />EACH OCCURRENCE S $2,000,000
<br />AGGREGATE S $2,000,000
<br />._.,.._,._
<br />EXCESS LIAr•S
<br />CLAIMS -MADE
<br />_µ..mDIED
<br />✓ RETENTIONSO
<br />S
<br />....2/1/201.5
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNERIEXECUTIVE Y❑
<br />WZ3A546821
<br />2/1/2016f
<br />SJN1TATUT-.-.. E PER I DERH
<br />E.L. EACH ACCIDENT S $1,000,000
<br />OFFICERfMEMSER EXCLUDED?
<br />(Mandatory In NH)
<br />NIA
<br />E.L. DISEASE - EA EMPLOYEE S $1,00(),00()
<br />E.L. DISEASE, - POLICY LIMIT ' $ $1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />I
<br />D
<br />Professional Liability
<br />MCF128829'4144
<br />9/20/2015
<br />9120/2016
<br />Per Claim: $1,000,000
<br />Aggregate: $2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 141, Additional Remarks Schedule, may be attached if more space Is required)
<br />Projects as on file with the insured including but not limited to San Lorenzo Lift Station & San Lorenzo Litt Station MND, T&B Project No. 788 -XXX.
<br />City of Santa Ana is named as additional insured on the general liability policy -see attached endorsement.
<br />a I
<br />ULKIH-IGAIt NULLItK
<br />Cit of Santa Ana
<br />Public Works Agency
<br />Corporate Yard, M-84
<br />229 S. Daisy Ave.
<br />Santa Ana CA 92763
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH TIRE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />MiChael Christian
<br />0)19'88-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />2647e1z0 1 15-16 GIALUL WC -FL I Sherry Y ... 9 1 9/18/2015 10.IS:44 All, CPDD) I €34. a of 4
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