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y <br />CERTIFICATE OF LIABILITY INSURANCE <br />OATC- I /201Y <br />QLIR ]IFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO At ..L TI4E TERMS, <br />9f 22f2p4 <br />14 <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 AODITIDNAL INSURED, the Policy(ies) must be endorsed. It 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 Hat confer rights to the <br />Certiticafe holder in lieu of SUCK endorsement {sj. <br />PRODUCER <br />f QNTACI �rJ <br />NAME:..._ <br />The Empire Company <br />__.__.._.._..- <br />PHONE <br />JM -. dhurnada y N+am p' re -ca. roan <br />550 North Park Center Drive <br />Suite 205 <br />INSURER, AFFORDING COVERAGE .. <br />NAICIt <br />.. --- -- <br />Santa Ana CA. 92705 <br />INSUrsBRA Hanover Insurance Ca. <br />_ _ _ _. _ <br />INSURCU - �- � <br />INSURER B Allmerica, Financial,. Benefit <br />I <br />1NSOnEec;LvFassachnsetts 13a�r Inauxance <br />Transportation Studies, Inc. <br />__ <br />INSURER D:United_States LiatTiti <br />" 5695 <br />2640 Walnut Avenue <br />INSURER E: <br />Unit: H <br />Tustin CA 9 2780 <br />rteRF <br />�nercon r-GC rcpTIVIr.h.TF An ItUIPPET:2019 /2015 Master REVISION NUMBER: <br />T1418 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED EQ THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED NOT'eYTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONRACT OR OTHER DOCUMENT WITH RESPECT 'FO WHIMI THIS <br />QLIR ]IFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO At ..L TI4E TERMS, <br />EXCLUSIONS AND CONDIT IONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. <br />LTRtrVPEOFid3URAttlCF <br />LEE." <br />- <br />AIJ�L <br />SULtR <br />PD[UC1 N4fd.DER <br />POLICY OFF <br />1 1 <br />POLICY FXP <br />R ) UtYY�Y� <br />LIMITS <br />GENERAL LIABILITY <br />EACHO CURRENCE <br />S 1,000,000 <br />o qM1 c`Ei ©FErHEe <br />30 ' 000 <br />X C IMFhC:�rL GCWLRFL tIAHIGITY <br />! <br />PR ry1�41$�PCC1 ce} <br />-� <br />fe1fO EY'+(A Y One fmr onV <br />S ___ 5, 000 <br />CLAI D15-MAOE � OCCUR <br />1 <br />83A11.?24901 �10 <br />/Y/ ?.019 <br />R0; 1/2tl1S <br />I <br />PERSONAL .SApV INJURY <br />S 1,000,000 <br />GErIEk L AGGREGATE <br />°a 2,000,000 <br />FEN AOGRECATE LdIT WPUFS PER: <br />POLI PPO IOC_. <br />AUTOMOBILE <br />PRG DUCTS - COtAPDPA G <br />. 2,000,0017 <br />-•—�— <br />j <br />I <br />- ""'�' <br />"" <br />� "'" <br />i.,01,1UNED 51NLLE IMIr <br />X ANY AD TO <br />t <br />QO It Y INJURY FAr Donor ) <br />tL.0 -ANbtD SCHEOULED <br />AUTOS NON-OWNED OWNED <br />1 ` <br />_ I IPrD AUTO AUTOS <br />JAEFIA11TIGS01 <br />1011 /2014 <br />'011/2015 <br />BOU { NJUR. (P a cdn,l)11 <br />__ <br />PROM RTY WtM1t4€ . <br />r'+? ae ^ttlll4.. =W <br />$ <br />3 <br />5 <br />U0.9nFiLI.LA LIAR X r.LIR <br />I <br />EACH (lG..t1P.RCNCc <br />EXCLnr UAO CLN \M1S- tAP.DC <br />' <br />AGGRE6.TE <br />EMPLOERS <br />T"" OTI-LIS <br />AND( LLAUIIJ YrLXLCUlIVE Y]N <br />N)AI <br />AC:C49 <br />1_LOU�- <br />IEH <br />C LDCASEEAETAFOYES <br />CLO LA�e- PO4fYLIMII <br />S 1000000 <br />_- 1_— <br />5_ .I 000_,..ORO <br />_7lFSGPIPT1G6b�JPFPA03I5 <br />OFFIrR1yICNHjEXLUOCC <br />IPlund'ttory <br />i II, NH) <br />If ya d -6nibe nrdm <br />T hnn* <br />1 <br />153A11724401 <br />10/1/201II <br />0/1/2015 <br />,_...__ <br />D <br />Errors G:huffs5lonS <br />.aP "_0227430 <br />10/1/2014 <br />nH(I /20x,5 <br />LIMIT <br />1,000;000 <br />RETENION <br />1, 000 <br />DESCRIPTION OF OPERATIONStLOCATIONS) VEHICLES IAfiSCh AGGRO111 ,Additional AUmaHV =ticherluk, Fl re sNaceisrey iredF <br />R's: On -Cal.l traffic counting service. Certificate Bolder is naaned as additional insureds with primary <br />and nun- contri.hutory wording with respect to general liabilty per forms 391 -1006 05 09 & 391-1331 06 09 <br />attached as required by written Contract- <br />) <br />SHOULD ANY OF TIME ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of Santa Ana <br />Attn: Shahir Gobran <br />20 Civic Centex plaza, M -43 AurHOR¢ED REPHESeNrnnvs <br />Santa Ana, CA 92702 <br />Erica Hornaday /ERICA <br />ACORD 251(2010=1 _ ©1988 -2810 ACORD CORPORATION. All rights reserved. <br />INSB25 %Btoos)01 The ACORD name and logo are registered marks of ACORD <br />