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<br />7 49!
<br />ACCN?� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIODNYYY)
<br />7r17r2015
<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(les) 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 Ileo of such endorsement(s).
<br />PRODUCER
<br />Dooley, Renton & Associates
<br />P. 0. Box 1o55D
<br />Santa Ana, CA 92711-0550
<br />CONTACT Sandy Peters_
<br />PH�AJOONe1tr.Ee[)_ 626 844-3070 'WAX, N9). 626 84A-3074
<br />EMAIL
<br />.eoDJTEsa. speters@deaioyrenton.com
<br />INSURER(B) AFFORDING COVERAGE NAICN
<br />License#0020739
<br />INSURER A Travelers Indemnity Co. of Connect! 25682
<br />INSURED CIVILSOUR
<br />INSURER BJravelers Property Casually Co nfA _� 25674
<br />_
<br />CivilSource, Inc,
<br />INSURER aiTravelers Casualty&Surety Co of Ame_� 31194
<br />9890 Irvine Center Drive
<br />Irvine, CA 92618
<br />INSURER D;,
<br />949 585-0477
<br />INSURER E:
<br />_
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 1973460479 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.
<br />MSR
<br />LTHTYPE
<br />Or INSURANCE
<br />01
<br />INSDI
<br />S:
<br />D'
<br />POLICY NUMBER
<br />POLI YEFF
<br />MMIDOIYYYY
<br />POLICYEXP
<br />MMIDUIYYYY
<br />LIMITS
<br />A
<br />X I COMMERCIALGENCRAL LIABILITY
<br />CLAIMS.MADE 111 OCCUR
<br />Y
<br />Y 16002B10L758
<br />7/20/2015
<br />1
<br />7120/2016
<br />EACH OCCURRENCE
<br />DAMAG TO Kite l�u
<br />PRE ISEB ERacmne o0
<br />$2,000,000
<br />51000,004___
<br />MED EXP (Any Dna person
<br />510,000
<br />X Con ractual Llab
<br />X XCUIDCIuded
<br />PERSONAL &ADV INJURY
<br />52,000,ODO
<br />AGGREGATE LIMIT APjPL�IES PER:
<br />GENERAL AGGREGATE '$4,000,000
<br />PRODUCTS COMPIOPAGG
<br />$4000,000
<br />_GENT
<br />POLICY ❑X C 1:1 LOC
<br />3
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />Y
<br />BA4592L377
<br />71201201$
<br />712012016II
<br />(Ea eocNdeotllNGLE LIMIT
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />_
<br />$
<br />ANY AUTO
<br />ALL OWNED gqUTOSULED
<br />rH{
<br />X HIRED AUTOS �A NOSWNED
<br />AUTOS
<br />a001LY INJURY (Par aooident)S
<br />PRO €R'I'Y 13AfV --
<br />Pet acdden0 �$
<br />_..__...._._
<br />_, __
<br />_
<br />Fs
<br />B
<br />X
<br />UMBRELLA LIAR X
<br />OCCUR
<br />Y
<br />Y
<br />CUP6772Y251
<br />'712012015
<br />7120/2015
<br />EACH OCCURRENCE
<br />$1,000,000
<br />_
<br />AGGREGATE _
<br />$1,000,000
<br />EXCESS LIARI
<br />CLAIMS -MADE
<br />DEC x RETENTION $0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' UABIUrY
<br />ANY PROPRIETORIPARTNERIEXECUTIVF- YIN
<br />y
<br />t1Be771 Y518
<br />7720/2018
<br />7120/2016
<br />Eq
<br />X 3TA7t-, Off.._
<br />E. L. FACH ACCIDENT
<br />j$1000000_
<br />E.L, DISEASE -EA EMPLOYEE[
<br />$1,000,000
<br />OITICEMMEMDER EXOLUDFD?
<br />(Mandatary in NF1)
<br />EL.DISEASE-POLICY LIMIT
<br />51,000000
<br />Ifyes describe under
<br />DESCRIPTION OF OPEHATGNSbelmy
<br />C
<br />Profeoaloral Liability
<br />Claims Made
<br />105960526
<br />[7/2012016
<br />712012016
<br />$2,000,000 Per Claim
<br />$2,000,000 Annua[ Aggregate
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONSIVEHICLES (ACORp'101, Addl9onnl Rsmarks Schedule, any bo attaehad If mere space Is mryuiratl)
<br />*General Liability polleyy excludes claims arising out of the performance of professional services."
<br />""Umbrella policy is a follow -form to underlying General LiabilitylHired&Non-Owned Aute Liability/Employers Liability.*'
<br />Re: City Engineering Services -- City of Santa Ana and their officers, agents and employees are named as additional insured as respects
<br />general and hired/non-owned auto liability for claims arising from the operations of the named insured as required per written contract.
<br />Insurance includes primary and non-contributory warding per the attached enclorsement(s). Insurance coverage includes waiver of
<br />subrogation per the attached endorsement(s).
<br />CERTIFICATE HOLDER CANCELLATION 30 Day NOC/10 Day for NonPay Of Prem
<br />@ 1988.2014 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE AEOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE
<br />THEREOF', NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />I
<br />Au ORIZED RBPRE NTATNE
<br />P - '#
<br />@ 1988.2014 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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