CALIFORNIA PROFESSIONAL ENGINEERING 2A-2015

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DATE (MM /DD/YYYY) A > CERTIFICATE ®F LIABILITY INSURANCE L 3/31/2016 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(ies) must be endorsed. If SUBROGRATION 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 endorsement(s). PRODUCER OnPoint Underwriting Inc. CONTACT NAME: Steven McComb 8390 E Crescent Pkwy, Suite 200 PHONE (A/C, No Ext): (360) 828 -0644 FAX (A/C, NO): (360) 828 -0699 Greenwood Village, CO 80111 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A ACE American Insurance Company 22667 INSURED INSURER B: Barrett Business Services, Inc. L /C /F INSURER C: CALIFORNIA PROFESSIONAL ENGINEERING INC. INSURER D: 929 OTTERBEIN AVE UNIT E INSURER E: LA PUENTE, CA 91748 INSURER F: COVERAGES CERTIFICATE NUMBER: RFVIRION NI IURFR- 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 ISSUES 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 OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MM /DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY V } 7 �._�..�pOCCUR I�f DAMAGE TO RENTED PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ....- .,.._'] �......,...... LOC PRODUCTS - COMP /OP AGO $ CC ECTOJ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ .ALL OWNED AUTOS SCHEDULED AUTOS w„ BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ W „ EXCESS LAB OCCUR AGGREGATE $ DED I� RETENTION $ $ A WOBRKERS COMPENSATION AND EMPLOYERS' Y/N RWC C48554647 12/01/15 12/01/2016 � WC STATU- TORY LIMITS OTH- JER ANY PROPRIETOR /PARTNER/ EXECUTIVE Y OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N / A Covered states: CA E.L. EACH ACCIDENT $2,000,000 E.L. DISEASE - EA EMPLOYEE $2,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) R6. VIFW C) C,Y � l UNICuE HEREDIA PG CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATA THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 'tt Richard Poling i./ 1 auu -w 1 u —urw I..VKruNm I IuIV. HII rignts reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD.