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A�. :Z-oIUf, 1 -1.)C),01
<br />"` xc �.rE1�.T'FICI`E LIABILITY INSURANCE
<br />[7ATLIMMlDl7lYY'YY)
<br />09f29f2016
<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: It 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 endorsement(s).
<br />PRODUCER
<br />Aon Risk 'Services Central, Inc..
<br />Pittsburgh PA office
<br />'CONTACT
<br />N AME:
<br />(aCNNo. Ext): (866) 283 - 712X. (800) 363 -0105
<br />Dominion Tower, 10th Floor
<br />625 Liberty Avenue:
<br />E -MAIL
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />N�AIC tI
<br />Pittsburgh PA 15222 -3110 USA
<br />INSURED
<br />INSURER A: Liberty Mutual Fire Ins CO
<br />2303.5
<br />Michael Baker International, Inc.
<br />INSURER B: Liberty Insurance corporation
<br />42404
<br />PU Box 57057
<br />Irvine CA 92619 -7057 USA
<br />INSURER C: National Union. Fire Ins CO of Pittsburgh
<br />19445
<br />INSURER D: Lloyd's syndicate No. 2623
<br />AA1128623
<br />INSURER E:
<br />$100,000
<br />INSURER F.
<br />COVERAGES CERTIFICATE NUMBER: 570059597267 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 />INSR LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />hIMJDD
<br />MMIODIYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL. GENERAL LIABILITY
<br />T9 268100414S715
<br />EACH OCCURRENCE
<br />$2, 000, 000
<br />CLAIMS -MADE —OCCUR .
<br />DAMAG TO RENTED
<br />PREMISES Ea occurrence
<br />$100,000
<br />MED EXP (Any one person)
<br />S5,000
<br />PERSONAL 8 ADV INJURY
<br />$2,000,000
<br />'.
<br />GEWL
<br />AGGREGGA-T-�E LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$4,..000,000
<br />POLICY y X pPRO- �LOC,
<br />L_� JECT
<br />PRODUCTS - COMPIOP AGG
<br />$4,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE LIABILITY
<br />A52- 681. - 004145 -725
<br />08/30/20155
<br />08/30/2016
<br />COMBINED SINGLE LIMIT
<br />Ea accident)
<br />$1,000,000
<br />BODILY INJURY ( Per person)
<br />: ANY AUTO
<br />BODILY INJURY (Per acuderl)
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />JX
<br />HIRED AUTOS y( NON - GOWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per accident
<br />C
<br />X UMBRELLA LIAR
<br />I X
<br />I OCCUR.
<br />SE033086983
<br />08/30/2015
<br />08/30/2016
<br />EACH OCCURRENCE
<br />$10,000700
<br />EXCESS LIAR
<br />CLAIMS- MADE
<br />AGGREGATE
<br />$10,000,000
<br />DED I X RETENTIONS10,000
<br />B
<br />B
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR I PARTNER! EXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? I N C,
<br />(Mandatory In NH) L—J
<br />NIA
<br />wA768D004145775
<br />AOS
<br />lNCa6 8100414 5 7 s5
<br />wI
<br />08/30/2015
<br />08/30/2015
<br />08/3072016
<br />013 /so /2' .01Cz
<br />X I PER 107H-
<br />STATUTE IFR
<br />E.L. EACH'. ACCIDENT
<br />$1,()00,000
<br />E.L. DISEASE: -EA EMPLOYEE
<br />S1,000,000
<br />IE yS6 dcscnbe under
<br />DESCRIPTION OF OPERATIONS below
<br />E L. DISEASE- POLICY LIMIT
<br />S1,000,000
<br />D
<br />E &O -PL- Primary
<br />QC1502675
<br />08/31/2015
<br />08/31/2016
<br />Per Claim
<br />$S,000,000
<br />Professional & Pollution
<br />Aggregate
<br />$5,000,000
<br />SIR applies per policy ter
<br />s & condi
<br />ions
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddIldonal Remarks Schedule, may be attached if more space Is required)
<br />Re: On -call water Resource EngiIneering Services.
<br />The City of Santa Ana and its officers, employees, agents, volunteer's, and representatives are included as Additional insured
<br />on a Primary and Non -- Contributory basis, in accordance with the policy provisions of the General Liability policy.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />@1988 -2014 A'GOR6D CORPORATION. All rights reserved.
<br />ACCORD 25 (2014101) The ACCORD name and logo are registered marks of ACORD
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<br />$HOULD 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 />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza (M -:30)
<br />PO Box 1998
<br />Santa Ana CA 927021988 USA
<br />@1988 -2014 A'GOR6D CORPORATION. All rights reserved.
<br />ACCORD 25 (2014101) The ACCORD name and logo are registered marks of ACORD
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