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Client#: 25181 PSOMAS ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM0D1 Y) TYPE OF INSURANCE 4/27/2016 6 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 SUBROGATION 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 NAME: Jerry Noyola Greyling Ins. Brokerage /EPIC PHONE 770 -552 -4225 FAX 866- 550.4082 NO, EZt: (A/C, No: 3780 Mansell Road, Suite 370 -MA, ADDRESS: jerry.noyola @greyling.com Alpharetta, GA 30022 $1,000,006 PREMISES Ea occurr0ence 877908 -5619 INSURER(S) AFFORDING COVERAGE NAICq INSURERA: National Union Fire Ins Co of P 19445 INSURED INSURER B AGGREGATE LIMIT APPLIES PER: POLICY � JET Fx I LOC OTHER: Psomas INSURER C: PRODUCTS - COMP /OPAGG 555 South Flower Street; Suite 4300 $ Los Angeles, CA 90071 INSURER D: LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS HIRED AUTOS X AUTOS NON -OWNED AUTOS 4489706 INSURER E 04/01/201 INSURER F: $ 1,000,D00 BODILY INJURY (Per person) COVERAGES CERTIFICATE NUMBER: 16 -17 REVISION NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED 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 ADDLSUBR INSR MD POLICY NUMBER POLICYEFF MMIDDIYYYY POLICY EXP MMIDD /YYYV LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Contractual Llab. 5268212 04/01/2016 - 04/01/2017 EACH OCCURRENCE $1,000,006 PREMISES Ea occurr0ence $500,000 X MED EXP(Any one person) $25,000 GEN'L PERSONAL &ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY � JET Fx I LOC OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS - COMP /OPAGG $2,000,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS HIRED AUTOS X AUTOS NON -OWNED AUTOS 4489706 04101/2016 04/01/201 COMBINED SINGLE LIMIT Ea ac d cient $ 1,000,D00 BODILY INJURY (Per person) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAS EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICEWMEMBER EXCLUDED? ® (Mandatory in NH) If DESCRIPTION OF OPERATIONS below NIA 015893764 ADS (ADS) 015893765 (CA) 04/01/2016 04/0112016 04/01/201 04/011201 X PER OTH- STATUTE ER E. L. EACH ACCIDENT $1,000000 EL DISEASE -EA EMPLOYEE $1,000,000 EL .DISEASE - POLICV LIMIT $1,600,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 2SAN051100 & 4SAN020200; Agreement Nos. A- 2008 -219 & A- 2015 -167; City of Santa Ana On -Call Engineering Services 14 -037 & GIS Needs Assessment & Implementation Plan & Enterprise Asset Needs Assessment & Implementation Plan. The City of Santa Ana, officers, employees, agents & representatives are named as Additional Insureds with respects to General & Automobile Liability where required by written contract. The above referenced liability policies are primary & non-contributory where required by writteyi contract. (See Attached Descriptions) REVIEWED BY; . EUNICE HEREDIA (PG / OF F City of Santa Ana Public Works Agency 20 Civic Center Plaza, M -21 Santa Ana, CA 92702 ACORD 25 (2014/01) 1 of 2 #S481473/M457630 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JNOY1