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A br CERTIFICATE OF LIABILITY INSURANCE
<br />DATE /DDYYYY)
<br />05/233 /2016
<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 endorsement(s).
<br />PRODUCER LIC #0056172 1-888-845-2248
<br />McSherry & Hudson
<br />CONTACT
<br />NAME:
<br />PHONE
<br />408-550-2130 ( 408-550-2119
<br />(A/C. No ExtI: A/C No
<br />160 West Santa Clara Street
<br />Suite 715
<br />E-MAIL
<br />ADDRESS:
<br />X
<br />X
<br />San Jose, CA 95113
<br />INSURERS AFFORDING COVERAGE
<br />NAIC If
<br />INSURERA: TRAVELERS PROP CAS CO OF AMER
<br />25674
<br />X COMMERCIAL GENERAL LIABILITY
<br />INSURED
<br />Tanko Street Lighting, Inc.
<br />INSURER B: HISCOX INS CO INC
<br />10200
<br />DBA: Tanko Lighting
<br />INSURER C:
<br />INSURER D:
<br />220 Bayshore Blvd.
<br />INSURER E:
<br />San Francisco, CA 94124
<br />INSURER F:
<br />RK *PI QZ41AC17+ M071121WAN I =111110 I 11011:12 a'i1.1•Yd4114' NSU 091`811\■\I1hAIt] =1
<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 />INSIR LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR-
<br />POLICY NUMBER
<br />EFF
<br />MM DD YYYY
<br />MMIOLICY
<br />DDYYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X
<br />X
<br />630-847OL003—TIL-16
<br />05/19/1
<br />05/19/17
<br />EACH OCCURRENCE $2,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />DAMAGE PREMISESS ( RENTED 100, 000
<br />Ea occurrence $
<br />MED EXP (Any one person) $ 5,000
<br />CLAIMS -MADE 1�1 OCCUR
<br />PERSONAL & ADV INJURY ' $ 2,000,000
<br />GENERAL AGGREGATE $ 4,000,000
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OPAGG $2,000,000
<br />X POLICY PRO- LOC
<br />$
<br />A
<br />AUTOMOBILE LIABILITY
<br />X
<br />i X
<br />BA-8470L003—TIL-16
<br />05/19/1
<br />05/19/17
<br />COMBINED SINGLE LIMIT
<br />Ea accident $ 1,000,000
<br />BODILY INJURY (Per person) $
<br />X ANY AUTO
<br />ALLOSCHEDULED
<br />'.AUT
<br />UOSS AUTOS
<br />(
<br />-- -- ----- ----
<br />BODILY INJURY P $
<br />(Per accident)
<br />X 'HIRED AUTOS g NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE $
<br />Per accident
<br />($
<br />A
<br />X UMBRELLA LIAB
<br />X
<br />OCCUR
<br />CUP-8470L003—TIL-16
<br />05/19/1
<br />05/19/17
<br />EACH OCCURRENCE $ 3,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE $ 3,000,000
<br />DED RETENTION $
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE(
<br />OFFICER/MEMBER EXCLUDED? Y❑
<br />N I A
<br />X
<br />UB -4E963854-16
<br />05/19/1
<br />05/19/17
<br />X WCSTATU- �OTH-
<br />' O Y I 'S 1=
<br />---
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />B
<br />Professional E&O
<br />I
<br />MPL 4 .1
<br />5 9
<br />7
<br />Each Aggregate 2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />RE: Analyses.
<br />Additional Insureds: City of Santa Ana, its City Council, boards, commissions, their officers, employees and agents.
<br />RI-'Vl W6 D BY UNl t C & EREDIA (Pc O
<br />__. ...__
<br />✓. ...
<br />�i Irl, I nUwcrt %,1A r_LLH1IUIV
<br />City of Santa Ana
<br />Attn:Ross Annex
<br />Civic Center Plaza, 3rd Floor Reception
<br />Santa Ana, CA 94087
<br />USA
<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 />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
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