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Client#: 25326
<br />KPFFINCO
<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />1 /10/2017
<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
<br />NAME: Jerry Noyola
<br />Greyling Ins. Brokerage/EPIC
<br />PHONE 770-552-4225 Fax 86
<br />Ext : A/C, No): 6-550-4082
<br />3780 Mansell Road, Suite 370
<br />E-MAILo,
<br />ADDRESS: jerry.noyola@greyling.com
<br />Alpharetta, GA 30022
<br />INSURER(S) AFFORDING COVERAGE NAIL #
<br />INSURER A: Travelers Prop Casualty Co of 25674
<br />_
<br />INSURED
<br />INSURER B : The Phoenix Insurance Company 25623
<br />KPFF, Inc.
<br />INSURER C : Travelers Indemnity Company .11 25658
<br />1601 5th Avenue
<br />Lloyds of London
<br />INSURER D : y
<br />Suite 1600
<br />Seattle, WA 98101
<br />INSURERS:
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 16-17 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 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 />LTRR
<br />TYPE OF INSURANCE
<br />NSRL
<br />WVDR
<br />POLICY NUMBER
<br />MM/DDNYYY
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />11 X COMMERCIAL GENERAL LIABILITY
<br />.. CLAIMS -MADE � OCCUR
<br />6800031132477A
<br />(AOS)
<br />10/10/2016
<br />10/10/2017
<br />EACH OCCURRENCE
<br />$1,000,000
<br />_
<br />PREMISESOERENTED
<br />r nce
<br />$300 000
<br />MED EXP (Any one person)
<br />$5,000
<br />A
<br />X', WA Stop Gap
<br />680-6H805490
<br />10/10/2016
<br />10/10/201
<br />XContractual Liab.
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />(CA)
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />''. POLICY LJECO .....^IT 0 LOG
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />PRODUCTS - COMP/OPAGG
<br />$2,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />BA1283L587
<br />10/10/2016
<br />10/10/201
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X' ANY AUTO
<br />ALL OWNED x SCHEDULED
<br />AUTOS AUTOS
<br />X HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />C
<br />X'. UMBRELLA LIAB X OCCUR
<br />CUPOOOF630530
<br />10/10/2016
<br />10/10/2017
<br />EACH OCCURRENCE
<br />$10,000,000
<br />AGGREGATE
<br />$10,000,000
<br />EXCESS LIAB CLAIMS -MADE
<br />$
<br />DIED I X'.. RETENTION $10 000
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? �
<br />NIA
<br />XJUB5836Y21616
<br />10/10/2016
<br />10/10/201
<br />X PER OTH-
<br />E.L. EACH ACCIDENT
<br />$1 000 000
<br />=--
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />D
<br />Professional/
<br />B0146LDUSA1604384
<br />10/10/2016
<br />10/10/ 17
<br />er Claim $10,000,000
<br />Pollution Liab.
<br />Aggregate $10,000,000
<br />SIR $250,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Re: Contract #s A-2015-175 & A-2016-135 - Engineering Consultant Agreement; KPFF Job #1600031. The City of
<br />Santa Ana, its officers, employees, agents & representatives are named as Additional Insureds with respects
<br />to General Liability where required by written contract. Should any of the above described policies be
<br />cancelled by the issuing insurer before the expiration date thereof, 30 days' written notice (except 10
<br />days for nonpayment of premium) will be provided to the Certificate Holder.
<br />FtE:VIEVWED BY:EUNIC'E HEFELJ1 (PG � OF
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Clerk of the City Council ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza (M-30)
<br />P.O. Box 1988 AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702-1988 , 0
<br />©1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S637132/M564569 JNOY1
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