A 2-i'0
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />DATF(MM/Di
<br />09)2312016
<br />CERTIFICATE OF LIABILITY INSURANCE I
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />INSIR
<br />LTR
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />ADDL
<br />INSO
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />Lexington Insurance Company
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />0
<br />U_
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policyi must have ADDITIONAL INSURED provisions or be endorsed.
<br />INSURER B:
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the Policy, Certain policies may require an endorsement. A statement on
<br />19445
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />19429
<br />Aon Risk insurance Services West, Inc.
<br />0
<br />-NAME: FAX —
<br />PHONE (866) 283-7122 (800) 363-0105
<br />Los Angeles CA office
<br />�AJC. No. Ext):
<br />'a
<br />1
<br />707 Wilshire Boulevard
<br />0
<br />Suite 2600
<br />ADDRESS:
<br />$1,000,000
<br />INSURER F:
<br />_fR
<br />MED EXP (Any one person)
<br />Los Angeles CA 90017-0460 USA
<br />COVERAGES
<br />CERTIFICATE NUMBER: 570063791493
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<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 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, Limits shown areas requested
<br />INSIR
<br />LTR
<br />INSURED
<br />ADDL
<br />INSO
<br />1 INSURER A:
<br />Lexington Insurance Company
<br />19437
<br />Tetra Tech, Inc. I
<br />LIMITS
<br />INSURER B:
<br />National union Fire Ins Cc of Pittsburgh
<br />19445
<br />17885 von Karmen Ave.
<br />Ste. 500
<br />INSURER C:
<br />The Insurance Co of the State of PA
<br />19429
<br />Irvine CA 92614 USA
<br />$1,000,000
<br />INSURER D:
<br />American Home Assurance Co.
<br />19380
<br />INSURER I
<br />AIG Europe Limited
<br />AA1120841
<br />DAMAGE T1,1 RENTED
<br />Ea accureenee
<br />$1,000,000
<br />INSURER F:
<br />_fR
<br />MED EXP (Any one person)
<br />$10,000
<br />COVERAGES
<br />CERTIFICATE NUMBER: 570063791493
<br />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 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, Limits shown areas requested
<br />INSIR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSO
<br />B
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMI
<br />T
<br />POLICY EXP
<br />MMIDDNYYY
<br />IMID�iy
<br />LIMITS
<br />13
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />220 S. Daisy Avenue, Suite A
<br />Santa Aria CA 92703 USA
<br />GL6051604
<br />1777 64
<br />I
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS -MADE. OCCUR
<br />DAMAGE T1,1 RENTED
<br />Ea accureenee
<br />$1,000,000
<br />X
<br />_fR
<br />MED EXP (Any one person)
<br />$10,000
<br />X,C,U coverage
<br />PERSONAL &. ADV INJURY
<br />$1,0100,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$1,000,000
<br />POLICY E,,R�OT FXJ LOC
<br />PRODUCTS - COI AGO
<br />sl.,000,000
<br />OTHER.
<br />8
<br />AUTOMOBILE LIABILITY
<br />CA 319-45-11
<br />10/01/2016
<br />10/01/2017
<br />COMBINED SINGLE LIMIT
<br />(Ea aocidenI
<br />$1,000,000
<br />BODILY INJURY { Per I
<br />X ANY AUTO
<br />BODILY INJURY (Per accident)
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED AUTOS NON- OWNED
<br />ONLY AUTOS ONLY
<br />IX
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />ISO Policy Form CAP
<br />I
<br />I
<br />X
<br />UMBRELLA i
<br />IHI
<br />OCCUR
<br />TH1600053
<br />10/01/2016
<br />1010112017
<br />EACH OCCURRENCE
<br />$10,06-0,000
<br />EXCESS I
<br />CLAIMS-MADE
<br />AGGREGATE
<br />$10,000,000
<br />_5EFF
<br />7,,E7ENTION S100, 000
<br />C
<br />D
<br />C
<br />C
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR PARTNER ttCu,lvE I
<br />OFFICERWE!i EXrLUDEi I
<br />(Mandatory in I
<br />NIA
<br />wC014629374
<br />wc014629378
<br />sC014629379
<br />WC014629380
<br />10/01/2016
<br />10/01/2016'10/01/2017
<br />10/01/2016..10/01
<br />10/01/201610/01
<br />1010112017
<br />/2017
<br />/2017
<br />X � PER 0 TH-
<br />,,A i ER
<br />1 1
<br />E L. EACH ACCIDENT
<br />$1,000,000
<br />FL DISEASE-FA EMPLOYEE
<br />$1,000,000
<br />If yes describe under
<br />DESCRIPTION OF OPERATIONS below
<br />I L DISEASE - POLICY LA41T
<br />$1,000,000
<br />A
<br />Env contr Prof
<br />028182375
<br />10/01/2015
<br />IG/01/2017
<br />Each claim
<br />$5,000,000
<br />Prof/Poll I
<br />Agggregate
<br />SIR applies per policy terns
<br />& condi
<br />ions
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />RE: San Lori Lift Station project. City of Santa Ana-Public works Agency its officers employees, agents, volunteers and
<br />representatives are included as Additional Insured in accordance with Ne policy provisions of the General Liability policy as
<br />required by written contract, General Liability policy evidenced herein is Primary and Non-Contributory to other insurance
<br />available to an Additional insured, but only in accordance with the policy's provisions as required by written contract. Stop
<br />Gap coverage for the following states: OH, I i WY,
<br />-,)2,e,- I k
<br />icl
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />01988-2015 ACORD CORPORATION. All rights reserved,
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
<br />CANCELLEO BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
<br />IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City of Santa Ana-Public works Agency
<br />AUTHORIZED REPRESENTATIVE
<br />Attn: Ri I
<br />220 S. Daisy Avenue, Suite A
<br />Santa Aria CA 92703 USA
<br />01988-2015 ACORD CORPORATION. All rights reserved,
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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