PENCO ENGINEERING, INC. 3 - 2015

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A!•'E" CERTIFICATE OF LIABILITY INSURANCE °"TL(MMI°D/ YYYj 11 /20/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Dealey, Renton & Associates License 90020739 P. OBox 10550 Santa Ana CA 92711-0550 COACT PHONE FAX �Iialess _ INSURERRH AFFORDING COVERAGE NAIC N INSURER A :Travelers Casualt & Suret Co. Ame 31194 INSURED PENCO Enggmea meaning, Inc. 16842 Von Korman Avenue, Suite 150 INSURER a.American Automobile Ins, Co. 21840 INSURERC:Associated Indemnity Corp. — _ — Irvine CA 92606 INSURER D INSURER E - INSURER F: COVERAGES CERTIFICATE MI IMRPP- 1:$HH1 T hI H4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE Or INSURANCE 50 WVD POLICY NUMBER pMIDDYEFF MMIDOIYYYY POLICY EXP MhiIDDIYVYY LIMITS C X I COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR XX Contractual AZC80905277 7/21/2015 7/21/2016 EACH OCCURRENCE $11000.000 — T.1A L- R<�'Y EN� PREMISESIEac,ccwence $1,000,000 X MED EXP(Any one endn) $10.000 X I BFPD. XCU PERSONAL B ADV INJURY $1.000,000 DEAL AGGREGATE LIMIT APPLIES PER: POLICY El PRCT LOC O- JE GENERAL AGGREGATE $2,000.000 PRODUCTS - COMP/OP AGG 62,000,000 OTHER: $ B AUTOMOBILE X LIABILITY ANYAUTO MZAR0312991 7/21/2015 7/21/2016 COMBINED $1,000AU0 BODILY INJURY(Per person) $ X ALLOWNED CHEOULED AU705 Oro S HIRED AUTOS N AUTOBWNC° BODILYINJURY(Paraccidenu $ PERTYD b Peramldan! $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVL- OrPICER/MEMBER EXCLUDED4 (Mandatary in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WZPBI028890 [7/21J2;015 7/21/2016 X PEAT TE OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1.000,000 E.L. DISEASE. POLICY LIMIT $1.0011000 A Professional Liability Claims Made 106119195 7/21/2016 Per Claim $1,000,000 Ann[ Aggr $2,000,000 REVIEWED DY. Et1NtCE k-3EREC)lA (F'G. ern=/ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddUlonai Remarks $cheduie, moy be attached It morn spaco le roqulred) General Liability policy excludes claims arising out of the performance of professional services. Independent Contractors Included as respects to General Liability. 30 Day Notice of Cancellation/10 Day notice for Non -Payment of Prom Re: On Call Engineering Services. Agreement numbers A-2008-218 and A-2015-236. City of Santa Ana, its officers, employees, agents, volunteers and representatives are additional insured as respects to General Liability as required by written contract. Primary and Non -Contributing coverage applies to GL as required by written contract. Waiver of Subrogation or Rights applies to Workers Compensation policy only as required by a written signed contract prior to any loss occurring. City of Santa Ana 20 Civic Center Plaza -Ross Annex (M-36) Santa Ana CA 92701 ACORD 25 (2014/011 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I�QrL,vK_ �7YlCy1.P ©1 rho ACORD name and logo are registered marks of ACORD All riaht8