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Client#: 1266412
<br />305FLEMIENV
<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDNYYY)
<br />11/12/2014
<br />THIS CERTIFICATE IS ISSUED ASA 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 />PRODUCER
<br />BB&T Insurance Services
<br />of Orange County
<br />CONTACT Vanessa Maldonado
<br />PHONE FAX
<br />(AIC, 114-914-2956 aG,Ne877.297.1116
<br />ADDRESS: vmaldonado@bbandt.com
<br />2400 Katella Avenue Ste 1100
<br />Anaheim, CA 92806
<br />INSURERS AFFORDING NAIC #
<br />Liability CoRAGE
<br />INSURER A: Starr Indemnity &Liability C 38318
<br />INSURED
<br />INSURER B: American States Insurance Cc 19704
<br />Fleming Environmental Inc.
<br />1372 East Valencia Drive
<br />Fullerton, CA 92831
<br />INSURER C: State Comp Ins Fund of CA 35076
<br />INSURER D: Travelers Property Casualty Co 25674
<br />INSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 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 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 />LTR
<br />TYPE OF INSURANCE
<br />NSRL
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />MMIDDIYYYY
<br />MMIDDIYYYV
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />SISIEIL70137414
<br />09/0112014
<br />09101/2015
<br />EACH OCCURRENCE
<br />$1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />PREMISES Ea Deco ante
<br />$366 600
<br />CLAIMS -MADE a OCCUR
<br />MED EXP (Any one person)
<br />s25,000
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />X Pollution Liability
<br />X Professional Liab
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER'.
<br />PRODUCTS - CDMP/OP AGG
<br />$2,000,000
<br />POLICY X PRO Loc
<br />BI/PD Ded
<br />$$5,000
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />01CI7208722
<br />09/01/201409/01/201
<br />(EO. aBINEDISINGLE LIMIT
<br />1,006,000
<br />BODILY INJURY (Per person)
<br />$
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY(P., accident)
<br />$
<br />PROPERTY DAMAGE
<br />Peraccident
<br />$
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />A
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />SISIXNV71067214
<br />09/01/2014
<br />09/0112015
<br />EACH OCCURRENCE
<br />$5,000,000
<br />AGGREGATE
<br />s5,000,000
<br />X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION$O
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNERIEXECUTIVEY IN
<br />OFFICER/MEMBER EXCLUDED?
<br />NIA
<br />909791314
<br />05/01/2014
<br />05/01/2015
<br />X WCSTATU- OTH-
<br />E L. EACH ACCIDENT
<br />$1000000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mantlatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />D
<br />Rented/Leased
<br />QT6606686M19ATIL14
<br />09/01/2014
<br />09/0112015
<br />$160,000 Max Per Item
<br />Equipment
<br />Ded: $1,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />RE: RFP #13-064 Site Improvements for New Propane Fueling Station - Santa Ana Corporate Yard.
<br />City of Santa Ana, its officers, agents and employees are named as additional insured as respects general
<br />liability, and this insurance is primary and noncontributory with any other insurance of the additional
<br />insured as required by written contract, per attached endorsement(s).
<br />FLEMMING ENVIRONMENTAL- AGREEMENT # TBD
<br />REVIEWED BY: �j� \ EUNICE HEREDIA (PG. 1 of 2)
<br />City of Santa Ana
<br />Attn: Purchasing Department
<br />20 Civic Center Plaza M-16
<br />Santa Ana, CA 92702
<br />ACORD 25 (2010/05) 1 of 1
<br />#Sl3254846/M12967409
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />@ 1988.2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />VLMAL
<br />
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