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A4CC>Ra CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMlDDl7'YYY) <br />11A1117PY1� i <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 endorsement(s), <br />PRODUCER <br />CONTACT <br />NAME: <br />Dealey, Renton & Associates <br />1 ._....,._._.._. <br />PHONE 714 427 6810 G FA3LW 71�k M27µ6818 <br />No,Ext): ___.. (Afc Nat __.1 _.I <br />License #0020739 <br />P. �. Box 10550 <br />E-MAIL rlee �le renton.com <br />'�dea_ y <br />Santa Ana CA 92711-0550 <br />ry— <br />INSURER(S) AFFORDING COVERAGE NAIC N <br />. .... ..._ <br />INSURER A:ACE American Insurance; Company <br />22667 <br />INSURED PSOMAS <br />. INSURER B: <br />PSOMAS <br />w. <br />INSURER C:: <br />_... <br />555 South dower Street, Suite 4300 <br />CLAIMS -MADE OCCUR <br />Los Angeles CA 90071 <br />INSURER D: <br />INSURER E: <br />$ <br />@NSURIER F: <br />$ <br />('nVFPAr,,FS rFIRTIPIrB TF MI IKARI=P- 2114791QIA 0C111C1nr1 A111RAMCO. <br />THIS IS TO CERTIFY THAT THE POLIC'iES 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. <br />NsR ..w_ _.. ADDE. SUB1i __._... __ _.,......._ EXP <br />LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER MMIDDfY'YYY MMMDYfYYYY LIMITS <br />COMMERCIAL GENERALLIABILITY <br />EACH OCCURRENCE <br />$ <br />DAMAGE'f RENTED <br />CLAIMS -MADE OCCUR <br />PREMISES Ea.occurrence <br />$ <br />ME .D EXP (Any one person) <br />$ <br />.__..r._._. <br />PERSONAL. & ADV INJURY <br />$ <br />GEN'LAGGREGATELIMITAPPLIESPER: <br />GENERAL AGGREGATE <br />$ <br />PRO- <br />........._. <br />.....,._ <br />PO JECT LOG <br />PRODUCTS COMPIOP AGO <br />.__.._ <br />$ <br />......_.a .............. <br />'...., $ <br />OTHERS <br />AUTOMOBILE <br />LIABILITY <br />',. <br />I SP NGLE <br />(Ea accident) <br />m... <br />.._......_. <br />ANY AUTO <br />BODILY INJURY (Per person) <br />$ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY Per accident <br />._ ( ) <br />$ <br />NON-OWNED <br />HIREDAUTOS AUTOS <br />PRO AGE Y DAMAGE <br />ERTn�_ <br />......... <br />$ <br />Per <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />$ <br />DEO I I RETENTION $_ <br />$ <br />WORKERS COMPENSATION <br />PER OTH- <br />.. <br />AND EMPLOYERS' LIABILITY YIN <br />STATUTE. ER <br />E.L. EACH ACCIDENT... <br />..._ ..,. <br />$ <br />ANY PROPMETORFPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />N/A <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE <br />S <br />If yes, describe under <br />-- <br />- --- - -- <br />DESCRIPTION OF OPERATIONS below <br />F DISEASE - POLICY LIMIT <br />$ <br />A <br />Professional Liability <br />623638381007 <br />10115/2015 <br />10/1512016 <br />Per Claim $1,000,000 <br />Claims Made <br />Annual Aggregate $1,000,000 <br />DESCRIPTION OF OPERATIONS d LOCATIONS I VEH@CLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />30 Day Notice of Cancellation /10 Day notice for Non- Payment of Prern <br />2SAN41011 1; Walnut Pump Station Upgrade Project/ Agreement NO.= A- 2014 -224 <br />L.L.A I IUIN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.. <br />Attn: Rudy Rosas <br />220 S. Daisy Avenue, M -85 AU HORIZED REPRESENTATIVE. <br />Santa Ana CA 92703 <br />J k o', P <br />V 1988 -2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />­k/ �. <br />