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A�ORo® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE( MIDDN Y)
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Woodruff -Sawyer & CO.
<br />2 Park Plaza, #500
<br />Irvine CA 92614
<br />NAME: NTACT Katharine Tiller
<br />PHONE FAX
<br />c • 949.435.7353 Alc No): 949.476.3118
<br />A DRESS: ktiller@wsandco.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Illinois Union Insurance Company
<br />27960
<br />INSURED ITERINC-01
<br />Iteris, Inc.
<br />1700 Carnegie Avenue, Suite 100
<br />INSURER B: ValleyFore Insurance Company
<br />20508
<br />INSURERC:
<br />INSURERD:
<br />Santa Ana CA 92705-5551
<br />INSURER E:
<br />__4=
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 1832644987 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />AD
<br />iSUBR--
<br />...-_.-
<br />POLICY NUMBER
<br />MMIDDY/YYYY
<br />MMIDDIYYXYY
<br />LIMITS
<br />B
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE Xi OCCUR
<br />Y
<br />8057382701
<br />4/1/2018
<br />4/1/2019
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />_
<br />A ED
<br />PREMISES Ea occurrence
<br />—
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />_
<br />$15,000
<br />X
<br />BI Ded. No,.
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />_
<br />$ 2,000,000
<br />POLICY JE� U LOC
<br />PRODUCTS - COMP/OP AGG
<br />i
<br />i $ 2. 00,000
<br />$
<br />X OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />6057362682
<br />I 4/1/2018
<br />4/1/2019
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1 000000
<br />BODILY INJURY (Per person)
<br />—
<br />$
<br />X
<br />ANYAUTO
<br />1
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident)_ _..,
<br />—
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />$ Dad's $1000
<br />Owned/Hired Comp/Coll
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />I
<br />6057362679
<br />4/1/2018
<br />4/1/2019
<br />EACH OCCURRENCE
<br />$ 26.000,000
<br />AGGREGATE
<br />$ 25.000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I X I RETENTION $
<br />$
<br />B
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />6057544401 4/1/2010
<br />8057544415 ( 4/1/2018
<br />H
<br />4/1/2018 IX STATUTE OR
<br />4/1/2019
<br />----
<br />$ 1,000,000
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />NIA
<br />E.L. EACH ACCIDENT
<br />-----------
<br />$ 1,000,000
<br />(Mandatory In NH)
<br />E.L. DISEASE- EA EMPLOYEE
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,0o0
<br />A
<br />Professional Liability
<br />Claims Made Form
<br />I
<br />G21650045015 4/1/2018
<br />4/1/2019 Limit $10,000,000/
<br />i Deductible $25,000
<br />Agg $10,000,000
<br />Retro-Date 01101/1991
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />RE; Provide signal design and signal timing services to the City of Santa Ana and project stakeholders along the Harbor Boulevard TSS corridor / Iteris Project#
<br />17J161729 & 17J161730
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insured, coverage is considered Primary and
<br />Non -Contributory and Separation of Insured's applies with respect General Liability per forms attached.
<br />Notice of Cancellation applies with respect General Liability per form attached. —
<br />REVIEWED BY: EUNICE HEREDIA (PG �OF
<br />Ll
<br />GER FIFIGA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana, City Of ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Clerk of the City Council
<br />20 Civic Center Plaza (M-30) / PO Box 1988 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702-1988 Vt.
<br />VQW
<br />91988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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