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FLEMING ENVIRONIVIENTAL, INC A-2014-273 REVIEWED BY
<br />Client#: 1266412
<br />EUNICE HEREDIA (PG 1 OF 2)
<br />305FLEMIENV
<br />ACORD. CERTIFICATE OF LIABILITY INSURANCE FATE (MMIDD/YYYY)
<br />08/2812015
<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 a"n, 'ADD ITIONAL. INSURED, -the po licy("Ies) roust be endorsed. If SUBROGATION IS WAIVED, s- ubje _ctto
<br />the terms and conditions of the policy, certain polIcles 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 />CONT CT
<br />NAIVE Kay Vongsoury
<br />BB&T Insurance Services
<br />PHONE -941-2922 7-297-1116
<br />JAI-- .714
<br />of Orange County
<br />E-MAIL kvongsoury@bbandt.com
<br />ADDRESS:
<br />2400 Katella Avenue Ste 1100
<br />SISIEIL701137415
<br />Anaheim, CA 92806
<br />INSURER(S) AFFORDING COVERAGE_NAIL
<br />.
<br />INSURER A: Starr Indemnity & Liability Co
<br />138318
<br />INSURED'
<br />INSURERS: American States Insurance Co
<br />1-004
<br />Fleming Environmental Inc.
<br />INSURER C: Cypress Insurance Company (CA)
<br />10855
<br />1372 East Valencia Drive
<br />INSURER D: Travelers Property Casualty Co
<br />25674
<br />Fullerton, CA 92'831
<br />X Pollution Liability
<br />I
<br />INSURER F:
<br />$25,000
<br />COVERAGES CERTIFICATE NUMBER: REVISION NLJMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME .. D 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 />-N -SR
<br />1
<br />,T.7
<br />LTR
<br />TYPE OF MSURANCE
<br />JA DLI
<br />IN3
<br />SR
<br />SUER
<br />POLICY NUMBERM
<br />POLICY FEE
<br />UDJYT)ff
<br />POLICY EXP
<br />MMIDDIYYYY)
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />SISIEIL701137415
<br />D9101/2015
<br />09101/201C
<br />EACHOCCURRENCE
<br />s1,9001000
<br />CLAIMS -MADE I F v -I OCCUR
<br />DAMAGE TO RENTED
<br />FIR EMISES fEa occurrence
<br />$300,000
<br />X Pollution Liability
<br />MED EXP (Any one person)
<br />$25,000
<br />X
<br />Professional Liab
<br />PLRS2N!AL & A11V INIURY
<br />51,00),000
<br />GENT
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />62,000,000
<br />PRO -
<br />POLICY 4 JECT 71 LOC
<br />PRODUCTS - COMP�OP AGO
<br />s2,000,000
<br />OTHER:-
<br />BI/PD De&
<br />$$5,000 Ded
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />01C17208723
<br />09/01120,15
<br />09/011201
<br />I COMBINED SINGLE LIMIT
<br />jEa accidep,�
<br />$1,000,000
<br />X
<br />ANY AUTO
<br />BODILY
<br />BODILY INJURY (Per parson)
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY Per accident
<br />-V
<br />$
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />DAMAGE
<br />$
<br />AUTOS
<br />(Per acmdenij
<br />P"
<br />A
<br />UMBRELLA LIAB A I OCCUR
<br />X
<br />SISIXNV71067215
<br />09/01/2015
<br />09101/201
<br />EACH OCCURRENCE
<br />$5,0_00000",.
<br />X
<br />EXCESS LIAR
<br />��Ny��DL
<br />AGGREGATE
<br />$5,_00000q,.
<br />nrD � X� RETENTION $0
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />FLWC6021!52
<br />05101/2015,:
<br />O�51011201 6
<br />PER IOTH-
<br />X "j,PTATUTE
<br />YIN
<br />ANY PROPRIETORIPARTNrFQEXECUTIVEL�]I
<br />OFFICERIMEMBER EXCLUDED?
<br />N$1,000,.000
<br />A
<br />E.L. EACH ACCIDENT
<br />;EA EMPLOYEE�
<br />1,000,000
<br />(MandatoryDISEASE
<br />It yes, descrIbe undar
<br />DESCRIPTION_PF. OPERATIONS below
<br />E1. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />D
<br />QT6606686M19ATIL15
<br />09/01/2015
<br />09/01/201
<br />$1,000 Deductible
<br />�Rented/Leased
<br />Equipment
<br />1
<br />$160,000 Max Per Item
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACOZ 101, Additional Remarks Schedule, may be attached it 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 andrioncontributory with any other insurance of the additional
<br />insured as required by written contract, per attached endorsement(s).
<br />City of Santa Ana
<br />Attn: Purchasing Department
<br />20 Civic Center Plaza M-16
<br />Santa Ana, CA 92702
<br />ACORD 25 (2014101) 1 of
<br />#S14734594/M14734566
<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 />44�
<br />0 1988.2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />HE
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