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A�CORa CERTIFICATE OF LIABILITY INSURANCE
<br />3/DATE(M 6 DIYYYY)
<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 endorsements .
<br />PRODUCER
<br />Woodruff -Sawyer & Co.
<br />50 California Street, Floor 12
<br />San Francisco CA 94111
<br />CONTACT
<br />NAME: Amber Wisher
<br />PHONE 415-391-2141 FAX 415-989-9923
<br />E-MAIL awisher wsandco.com
<br />@wsandco.com
<br />AFFORDING COVERAGE NAIC #
<br />Y
<br />INSURER A: Illinois Union Insurance Company 27960
<br />CP0553288002
<br />INSURED ITERINC-01
<br />INSURER B :American Guarantee and Liability In 26247
<br />Iteris, Inc.
<br />1700 Carnegie Avenue, Suite 100
<br />Santa Ana CA 92705-5551
<br />INSURER C :American Zurich Insurance Company 40142
<br />INSURER D
<br />INSURER E:
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 259094144 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.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />C
<br />x COMMERCIAL GENERAL LIABILITY
<br />Y
<br />CP0553288002
<br />4/1/2016
<br />4/1/2017
<br />EACH OCCURRENCE $2,000,000
<br />CLAIMS -MADE ❑X OCCUR
<br />DAMAGE(RENTED
<br />–PREMISES Ea occurrence)$2,000,0_00
<br />MED EXP (Any one person) $15,000
<br />X BI Ded. None
<br />PERSONAL & ADV INJURY $2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY ❑ PRO JECT F—]LOCPRODUCTS
<br />GENERAL AGGREGATE $4,000,000
<br />- COMP/OP AGG $4,000,000
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />CP0553288002
<br />4/1/2016
<br />4/1/2017
<br />COM Ea aocdeDt N LIMIT $1,000,000
<br />BODILY INJURY (Per person) $
<br />X1AUTOS
<br />ANY AUTO
<br />AUTLL OS OWNED SCHEDULED
<br />BODILY INJURY (Per accident) $
<br />HIRED AUTOS NON -OWNED
<br />PROPERTY DAMAGE $
<br />Per accident
<br />Owned/Hired Comp/Coll $Dad's $500
<br />B
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />AUC553288102
<br />4/1/2016
<br />4/1/2017
<br />EACH OCCURRENCE $25,000,000
<br />AGGREGATE $25,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION$0
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />EMPLOYERS' LIABILITY y / N
<br />WC019188400
<br />4/1/2016
<br />4/1/2017x
<br />STATUTE
<br />STATUTE ER
<br />EACH ACCIDENT $1,000,000
<br />ANY PRO PRIETO R/PARTNER/EXEC UTIVEE.L.
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />N I A
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT $1,00(1,000
<br />DESCRIPTION OF OPERATIONS below
<br />A Professional Liability G21656045013 4/1/2016 4/1/2017 Limit $5,000,000/ Agg $5,000,000
<br />Glamis Made Form Deductible $50,000
<br />Retro -Date 01/01/1991
<br />�tL"rn4IEWELL S FI �twtlC H REDI �.: �:� ��r�
<br />ww. OF -
<br />_ _. w __.w.ww_ ..
<br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 109, Add! $nal Remarks Schedule, may be attached if more space is required)
<br />RE: Provide signal design and signal timing services to the City of Santa Ana and project stakeholders along the Harbor Boulevard TSS
<br />corridor/ Iteris Project# P15GNRL 0246.16
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insured, coverage is
<br />considered Primary and Non -Contributory and Separation of Insured's applies with respect General Liability per forms attached.
<br />Notice of Cancellation applies with respect General Liability per form attached.
<br />t r—m I Irll./A 1 C r'IULUMM L ANt,CLLA I IUIN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana, City of ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Clerk of the City Council
<br />20 Civic Center Plaza (M-30) / PO Box 1988 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702-1988
<br />©1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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