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CERTIFICATE OF LIABILITY INSURANCE
<br />rATE(MM/DDr(YYY)
<br />02/02/201802/02/2018018o)a
<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 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 />Aon Risk Services Northeast, Inc.
<br />Stamford CT office
<br />CONTACT
<br />NAME:
<br />PHONE (866) 283-7122 FAX (800) 363-0105
<br />(AIC. No. Ext): (AIC. No.):
<br />E-MAIL
<br />ADDRESS:
<br />1600 Summer Street
<br />Stamford GT 06907-4907 USA
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />LIMITS
<br />INSURED
<br />INSURER A: Zurich American Insurance Company 16535
<br />United Testing LLC
<br />dba united -Heider Inspection Group
<br />22620 Goldencrest Drive, Suite 114
<br />INSURER B: Travelers Property Cas Co of America 25674
<br />INSURER C: Peleus Insurance Company 34118
<br />Moreno valley CA 92553
<br />INSURER D:
<br />1
<br />INSURER E:
<br />INSURER F:
<br />GUVtKAUtJ GtKIIhICATt NUMIitK: b/UUb1Jb1229 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 />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />POLICY PROVISIONS.
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
<br />Santa Ana CA 92701
<br />NSR
<br />ILTR
<br />TYPE OF INSURANCE
<br />D
<br />NSD
<br />UBR
<br />WVD
<br />POLICY NUMBERMMIDD/YYYY
<br />POLICY EFF
<br />POLICY EXP
<br />MM DD/YYYY
<br />LIMITS
<br />X COMMERCIAL GENERAL LIABILITY
<br />GLO
<br />1
<br />1
<br />EACH OCCURRENCE $1,000,000
<br />CLAIMS -MADE X❑ OCCUR
<br />DAMAGE FORM= PREMISES Ea occurrence)$500,000
<br />MED EXP (Any one person) $10,000
<br />N
<br />PERSONAL &ACV INJURY $1,000,000
<br />r-
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $2,000,005
<br />X POLICY F-X]
<br />JER� F LOC
<br />PRODUCTS - COMP/OP AGG $2,000,000
<br />OTHER:
<br />p
<br />I-
<br />AA
<br />AUTOMOBILE LIABILITY
<br />BAP0381006
<br />07/01/201707/01/2018
<br />COMBINED SINGLE LIMIT $1,000,00
<br />Ea accident
<br />BODILY INJURY ( Per person)
<br />X ANY AUTO
<br />O
<br />OWNED SCHEDULED
<br />y
<br />BODILY INJURY (Per accident)
<br />AUTOS ONLY AUTOS
<br />N
<br />PROPERTY DAMAGE
<br />HIRED AUTOS NON -OWNED
<br />O
<br />ONLY AUTOS ONLY
<br />Per accident
<br />4=
<br />d
<br />B
<br />X UMBRELLA LIAR
<br />X
<br />OCCUR
<br />ZUP81M3498017
<br />07/01/201;07/01/2018
<br />EACH OCCURRENCE $5,000,00
<br />C-)
<br />AGGREGATE $5,000,00C
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETEWORKERS NTION
<br />LIABILTYTION AND
<br />WC0381004
<br />07/01/201
<br />07/01/201
<br />STATUTE FTH-
<br />x IR
<br />A
<br />EMPLOYERS' YIN
<br />E.L. EACH ACCIDENT $1, 000 , 0O
<br />ANY PROPRIETOR I PARTNER / EXECUTIVE —N
<br />OFFICERIMEMBER EXCLUDED?
<br />[
<br />E.L. DISEASE -EA EMPLOYEE $1, 000' 00
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />—_
<br />E.L. DISEASE -POLICY LIMIT $1, 000, OO
<br />C
<br />Architects & Engineers
<br />JAE4197397
<br />06/30/2017
<br />6/30/2018
<br />Each Claim: $2,000,000
<br />Professional Liability
<br />Aggregate: $4,000,000_
<br />DESCRIPTION)F OPERATIONS LOCATIONS / VEHICLES ACORD 101, Additional RemarksSchedule, maybe attached ifmore space isrequired
<br />ray
<br />RE: Santa Ana Delhi Channel Diversion Project. Santa Ana, CA, C ty of Santa Ana
<br />Project 16-6467 UIT Project 10-17413Pw.
<br />The City of Santa Ana its officers, employees, agents and representatives are included as Additional Insured with
<br />respect to the provisions of the General Liability policy, as per attached endorsements, a primary non-contributory
<br />basis. waiver of Subrogation applies.
<br />r
<br />REVIEWED BY: EUNICE HEREDIA (PG OF
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />City Of Santa Ana
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />20 civic Center Plaza
<br />POLICY PROVISIONS.
<br />AUTHORIZED
<br />Santa Ana CA 92701
<br />(�REPRESENTATIVEj/'J
<br />l�sO�d �r�G>t2ilCC4 V !� c/ 9ZC
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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