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ya <br />'- CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDIYYYY( <br />6/2/2016 <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 certiflcate holder Is an ADDITIONAL INSURED, the Policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the <br />certificate holder in Had of such endorsemant(s). <br />PRODUCER <br />LAURIE BRENNAN HAUCK <br />9114 Adams Ave #182 <br />JUNIAOF <br />NAME:PHO <br />wc.rvo.Ea:(702)629-6700 ac,Nop(702)629-6701 <br />ADDRESS: br@RCC s01 . Com <br />Huntington Beach, CA 92646 <br />INSURERIS) AFFORDING COVERAGE NAIC4 <br />OC96533 <br />INSURER A: The Hartford <br />INSURED Assoc, Inc. <br />INSURER B: Trumbull Insurance Company 19666 <br />17782 Georgetown Lane <br />INSURER c: Houston Casualty Company <br />Huntington Beach, Ca 92647 <br />INSURER D: <br />(714) 375-3830 <br />INSURER E: <br />INSURER F: <br />MED _EXP (Any an ismah) .$. ....5000._ <br />COVERAGES CERTIFICATE NUMBER: RFVIFtMDAnRFR- <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 �ONTRACT 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 />CTR <br />TYPE OF INSURANCE <br />a R <br />WIM <br />POLICY NUMBER <br />(MMI <br />(MMIOD/YYVY) <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $2,000,000, <br />ii COMMERCIAL GENERAL LIABILIT <br />LCLAIMS-MAOE..CLOCCUR. __. <br />__ <br />___. - ._.. _.- -. <br />_. <br />__._ <br />PREMISES (Ea occurrence) $ 100,000. <br />MED _EXP (Any an ismah) .$. ....5000._ <br />A <br />% <br />Y <br />154BW32178 <br />6/24/2D15 <br />6/24/2016 <br />PERSONAL&ADV INJURY $2,000,000. <br />GENERAL AGGREGATE $2,000,000. <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPIOP AGO $2,000,000, <br />POLICY PRO - <br />ECT LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />Ea accident 1 , r 00 . <br />A <br />X <br />X <br />ANYAUTO <br />ALLOWNEOSCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS NON -OWNED X AUTOS <br />x <br />y <br />72UECTQ7770 <br />7/7/2015 <br />7/7/2016 <br />BODILY INJURY (Per person) S <br />.. <br />BODILY INJURY (Per aoddm) $ <br />Parr codws) A AGE $ <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE IS <br />EXCESS LIAB <br />CLAIMS-MAOE <br />AGGREGATE S <br />DEG RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORPARTNEWEXECUTNE <br />OFFICERJMEMBER CXCLUDED4 <br />(Mandatory in NH) <br />Ilyes, deacdbe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />7ZWECKU67 BO <br />9/11(2016 <br />4/11/2017 <br />x TORY LIMITS CER_ <br />EA. EACH ACCIDENT $ 1-,000,000 <br />E.L.DISEASE-EAEMPLOYEE 7T, O <br />E.L. DISEASE -POLICY LIMIT 5 1,000,000 <br />C <br />Professional Liab. <br />HCC1421080 <br />07/09/15 <br />07/09/16 <br />$2,000,000.per Claim <br />$2,000,000, aggregate <br />DESCRIPTION OF OPERATIONS ILOCATIONS (VEHICLES (Attach ACORD 101, Additional Remarks Schedule,it more space Is requiretl) <br />RE: RFP15-055 Geotechnical, special inspection & material testing; <br />A-2011-057-01 for inspection & testing Services <br />Certificate holder is named as an additional insured per the attach d form. <br />Primary/Non Contributory wording applies per the attached form <br />REVIEWED BY: r EUNICE HEREDIA(PO <br />City of Santa Ana <br />Its Officers, Employees, Agents <br />Volunteers and Representatives <br />20 Civic Center Plaza <br />Santa Ana, Ca 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ACORD CORPORATION AN Hi hiw raearvuH <br />ACORD25 (2010105) The ACORD name and logo are registered marks of ACORD <br />