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A �`'iJC ® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM /DDIYYYYI
<br />10/27/2015
<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 />Marsh USA, Inc.
<br />9830 Colonnade Blvd Ste 400
<br />CONTACT
<br />NAME:
<br />PHONE FA%
<br />E -MAIL TransForcecortRequests@Marsh.com
<br />San Antonio, TX 78230
<br />INSURERS AFFORDING COVERAGE
<br />NAIC H
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS MADE OCCUR
<br />INSURER A: National Union Fire Insurance Co. of PA
<br />19445
<br />CN1 03820276-Dyna-GAWXM-1 5-
<br />INSURED Dynamex Operations West, LLC
<br />2051 Raymer Avenue, Unit A
<br />INSURER B: Allianz Global Risks Us Insurance Company
<br />35300
<br />INSURER C: Liberty Mutual Fire Insurance Company
<br />23035
<br />Fullerton, CA 92833
<br />INSURER D:
<br />INSURER E:
<br />$ 10,000
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: HOU- 002697422 -09 REVISION NUMBER:12
<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 />LTR
<br />TYPE OF INSURANCE
<br />ADDDL
<br />SU D
<br />POLICY NUMBER
<br />MMIDDIYVEVYY
<br />MMIDDY�
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS MADE OCCUR
<br />GL1872136
<br />03/01/2015
<br />03/0112016
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />DAMAGE TO RENTED PREMISES E
<br />$ 10,000,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />$ 10,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PRO-
<br />JECT a LOC
<br />GENERAL AGGREGATE
<br />$ 10,000,000
<br />PRODUCTS - COMP /OP AGO
<br />$ 10,000,000
<br />$
<br />OTHER:
<br />A
<br />LIABILITY
<br />CA6506059
<br />03101/2015
<br />03101/2016
<br />COMBINED SINGLE LIMIT
<br />$ 10,000,000
<br />BODILY INJURY(Per person)
<br />$
<br />NY AUTO
<br />LL OWNED SCHEDULE[)
<br />FMOBISLE
<br />BODILY INJURY(Per accident)
<br />$
<br />UTOAUTOS
<br />IREDAUTOS NON- OWNED
<br />PPROPERTY DAMAGE
<br />$
<br />B
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />XYZ 000 5798 0336
<br />03101/2015
<br />03/01/2016
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$ 5,000,000
<br />DEC
<br />RETENTION$
<br />$
<br />C
<br />A DEMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIFXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />WA2B7D170841015
<br />0913012015
<br />09I30I2016
<br />X STATUTE oTH-
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE -EA EMPLOYEd
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT
<br />I $ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana, its Officers, Employees and Agents are recognized as an Additional Insured on General Liability and Auto Liability, as required by written contract.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City Of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />,:�til.;u..tc- 3•,a�..� -u-
<br />©1988 -2014 ACORD CORPORATION. All rights reservgd.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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