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"c- ° ®® CERTIFICATE OF LIABILITY INSURANCE
<br />DAT32M3 °o4YYY'
<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 Ileu of such endorsement(s).
<br />PRODUCER
<br />AOn R1 sk Services Northeast, Inc.
<br />New York NY Office
<br />199 Water Street
<br />New York NY 10038 -3551 USA
<br />CONTACT
<br />NAME:
<br />PHONE N o.Exp: (866) 283 -7122 FAX Nog (800) 363 -0105
<br />EMAIL
<br />ADDRESS:
<br />INSURERISI AFFORDING COVERAGE
<br />NAIC It
<br />INSURED
<br />INSURERA: Great Northern Insurance CO.
<br />20303
<br />ICF Jones & Stokes, Inc.
<br />9300 Lee Highway
<br />Fairfax VA 22031 -1207 USA
<br />INSURER B: sentry Ins A Mutual company
<br />249$$
<br />INSURER C: AXIS Surplus Insurance Company
<br />26620
<br />X
<br />INSURER D:
<br />$10,000
<br />INSURER E:
<br />PERSONAL B ADV INJURY
<br />$1,000,000
<br />INSURER F:
<br />COVERAGES CERF01CATE NUMBER: 570056319830 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 are as requested
<br />LTR
<br />TYPE OF INSURANCE
<br />AINSO
<br />WVD
<br />POLICY NUMBER
<br />POLICY IDDIYWY
<br />MMIDO YYXYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ❑X OCCUR
<br />Contractual Liability
<br />Package Domestic
<br />6 2
<br />EACH OCCURRENCE
<br />$1,000,000
<br />TOT970 ITTORIEWFE D
<br />PREMISES Ea accorrence
<br />$1,000,000
<br />X
<br />MED EYE (Any one person)
<br />$10,000
<br />PERSONAL B ADV INJURY
<br />$1,000,000
<br />q e it V
<br />GERLAGGREGATE UMITAPPLIES PER:
<br />GENERALAGGREGATE
<br />$2,000,000
<br />X POLICY ❑ PRO ❑ Lac
<br />JECT
<br />�
<br />PRODUCTS - COMPIOP ADD
<br />$2,000,000
<br />OTHER'.
<br />A
<br />AUTOMOBILE LIABILITY
<br />X ANYAUTO
<br />7352 -29 -55
<br />Automobile - All States
<br />06/25/201406/25
<br />..t
<br />1 G
<br />/2015
<br />COMBINED SINGLE LIMIT
<br />Eaeccident
<br />81,000,000
<br />BODILY INJURY (Per person)
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />Y
<br />BODILY INJURY (Per eccldant)
<br />PROPERTY DAMAGE
<br />Per accident
<br />X HIRED AUTOS X PON-OWNED
<br />AUTOS
<br />UMBRELLALIAS
<br />OCCUR
<br />EACH OCCURRENCE
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />AGGREGATE
<br />DED1
<br />RETENTION
<br />B
<br />B
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY ylN
<br />ANY PROPRIETOR I PARTNER I EXECUTIVE
<br />OFFICERIMEMBER EXCLUDEDP
<br />NIA
<br />90- 17657 -01
<br />Workers Comp
<br />90- 17657 -02
<br />06/25/2014
<br />06/25/2014
<br />06/25/2015
<br />06/25/2015
<br />PER STATUTE OTH.
<br />X ER
<br />E. L. EACH ACCIDENT
<br />$1,000,000
<br />to
<br />(Mandatory In NH)
<br />If doo"Ibe under
<br />Workers Comp
<br />E. L. DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />EL. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />C
<br />E &O -MPL- Primary
<br />EBZ768043/01/2014
<br />Errors & Omissions
<br />06/25/2014
<br />06/25/2015
<br />Prof- Liab Agq - All
<br />Overall policy aggr,
<br />$1,000,000
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Adorn .nal Remarks Sched.le, ma, be attached if more space Is r.qulmd)
<br />The City Of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insureds as
<br />their interests may appear with respects to General Liability.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />©1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />city of Santa Ana
<br />20 Civic Center Plaza (M -30)
<br />AUTHORIZED REPRESENTATIVE
<br />PO Box 1988
<br />Santa Ana CA 92702 USA
<br />©1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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