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A�R'EP CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMrDDrYYYY)
<br />0 "t12Gr20t8
<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: 9 the certificate holder is an ADDITIONAL INSURED, the pollcy(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 lieu of such endorsement(s).
<br />PRODUCER
<br />Marsh USA, Inc.
<br />9630 Colonnade Blvd $E 460
<br />San Antonio, TX 78230
<br />NAME:
<br />PHONE -- ._._......_..... FAX. ......___.
<br />j£r! &.,.Ns.. 11 :.............._.._._..._ AIC No.._............._._.....
<br />EMAIL
<br />ADDRESS:
<br />_ — ... _._ ...................... INSURERMt AFFORCiNG COVERAGE .._. _ _......_.
<br />NAIC A
<br />INSURER A: ACE American Insurance Company
<br />22667
<br />CN103820270- 6yna-GANtXM-16-
<br />_._... ........_.........___.......... ........._.,..—
<br />INSURED
<br />Dyn amax Operations West LLC
<br />051 R y mer Avenue, Unit
<br />-- ........._._
<br />INSURER a: Aluanz Global Risks Us insurance Company
<br />,__...._,
<br />35300
<br />_._- ...______...._...._ _........_...._
<br />INSURER c: s 'berly NJal Fire neuramce Company
<br />2505
<br />INSURER D: NIA
<br />WA
<br />Fullartml, CA 92&33
<br />_........_.._ ............. _..__......._._._..
<br />NSU E
<br />IRR E:
<br />INSURER F:
<br />$ 10 000,000
<br />COVERAGES CERTIFICATE NUMBER,. HOU- 002697422 -12 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 CONTRACTOR 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 REDUCED BY PAID CLAIMS.
<br />_
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />_BEEN
<br />POLICY NUMBER
<br />MMfdO YYYY
<br />_
<br />POLICY YYYY _LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />627405106
<br />03101PLD113
<br />OV0112017
<br />EACH OCCURRENCE _
<br />$ 10,000,000
<br />CLAIMS -MADE L I OCCUR
<br />-FARA-6-E TO REP O
<br />PREMISES G-s ov:_urrence
<br />$ 10 000,000
<br />MED EXP (Anyone person)_
<br />$ 10,000
<br />PERSONAL &ACV INJURY _
<br />$ 10,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE_
<br />$ 10,000,000
<br />X POLICY ❑ jEC F LOC
<br />PRODUCTS- COMPIOP AGO
<br />$ 10,000,000
<br />S
<br />OTHER'
<br />A
<br />AUTOMOBILE LIABILITY
<br />H69D41260
<br />03/01121
<br />_
<br />0310112DI7
<br />COMBINEOSINGLE LIMIT
<br />$ 10,000,000
<br />BODILY INJURY (Per person)
<br />S
<br />X ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTO$
<br />'', BODILY INJURY (Peraccidrim
<br />$
<br />HIRED AUTOS NON OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Par accident �
<br />$
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />XYZ000152272H
<br />03011(2016
<br />)3/0112017
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />-
<br />AGGREGATE
<br />5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />.„
<br />....�.._......_,...._.....
<br />DEU RETENTION
<br />F
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANY PROPRIETOWPARTMERIEXECUTIVE
<br />OFFICERIMENI EXCLUDED?
<br />(Mandatory In NH)
<br />NIA
<br />WA2KD1?0841015
<br />0913012015
<br />0913012016
<br />X PERTUTE ERH
<br />-
<br />E.L. EACH ACCIDENT
<br />-------- _,_..�
<br />$ 1,000,600
<br />E.L. DISEASE- EA EMPLOYE
<br />$ 1;000,006
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS Lrelrm
<br />_
<br />E.L. DISEASE -POLICY LIMIT
<br />_
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHIC'.LES (ACORD 1a1, Additional Remarks Schedule, may be attached If mora space is required)
<br />Cltyof San Ana, Its Ouncers, Employees and Agenls are recognized as an AddNonal Insured on General Liability and Auto Liability as required by wrlllen contract
<br />kit
<br />City Of Santa Ana
<br />70 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />SHOULD ANY 0'F THE ABOVE DESCRIBED POLICIES BE CANCELI.EID BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WJITH THE POLICY PROVISIONS.
<br />AUTHORI2Er5 REPRESENTATIVE.
<br />of Marsh U'SA Inc.
<br />.Sy'Lv- �.A+xow:
<br />rialits resxerverl.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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