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a� CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <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 Marsh Risk and Insurance Services CONTACT <br />r�nME_ Marsh Risk and Insurance Services <br />345 California Street PHONE FAX <br />Suite 1300 Wc. No, �xt}: 415-743-8000 _(ac, No);__ <br />EMAIL <br />San Francisco, CA 94104 ADDRESS,. <br />www.marsh.com <br />California License: OH01556 <br />INSURED <br />Kappsch TrafficCom Holding II US Corp. <br />8201 Greensboro Drive <br />Suite 1002 <br />McLean VA 22102 <br />COVERAGES <br />CFRTIFICATF Nt1MRFR- F9r4R7iQa <br />INSURE Is AFFORDING COVERAGE NAIC Y <br />INSURER A: AXA Insurance Company 33022 <br />INSURER B : Travelers PfODerty Casualtv Co of Amer 25674 <br />INSURER D. Charter Oak_ Fire Insurance Company 25615 <br />INSURER E <br />REVISION Nt1MRFR- <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 TYPE OF INSURANCE INSU ADnI: suB POLICY NUMBER POLICYFF MMIDDmYY LIMITS <br />R <br />A COMMERCIALGENERALLIABILITY <br />PCS003157(19) <br />7/1/2019 <br />7/1/2020 EACHOCCURRENCE <br />$1,00a000 <br />l CLAIMS -MADE �/ OCCUR <br />_ _ <br />}AMAGF rO RENTEV <br />PI{EMISFS jf=aoccurlArtcu), <br />$ t 00 QQO <br />, <br />MED EXP JNky Mu parson) <br />$ 1 O,000 <br />PERSONAL & ADV INJURY <br />. s 1,000,000 <br />..! fl'L AGGREGATF LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />POLICY PEA LOC <br />{ I..._l <br />mioDUCTs-CQMPIgPAGG <br />T <br />.s2.000000 <br />$,QQ QQQ <br />gTHER: <br />DedUctlblB <br />B AUTOMOBILE LIABILITY <br />810-1 N626414 <br />7/1/2019 <br />7/1/2020 <br />COMBINEDflISINGLE LIMIT <br />$1_ Q00 000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />$ <br />J <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />HIRED NON -OWNED <br />$ <br />AUTOS ONLY .�, AUTOS ONLY <br />$ <br />A <br />UMBRELLA LIAR �/ OCCUR <br />XS003158(19) <br />7/1/2019 <br />7/1/2020 <br />EACH OCCURRENCE <br />$5 QQQ Q�Q <br />AGGREGATE <br />EXCESS LIAR CLAIMS -MADE <br />$ 5 000,000 <br />DED ✓ RETENTION$ 10.000 <br />$ <br />WORKERS COMPENSATION <br />UB-OL500865 <br />7/1/2019 <br />7/1/2020 <br />f SPER OT <br />TATUTE ER <br />AND EMPLOYERS' LIABILITY <br />YIN <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />E,L, EACH ACCIDENT <br />$ 1 00000O <br />OFFICER/MEMBER EXCLUDED? nN <br />N / A <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE <br />§A.,000.000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />I E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />C .Tech E&O- Professional Liability <br />G25604635004 <br />7/1/2019 <br />7/1/2020 <br />$2.000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Contract Numbers: A-2016-057 and A-2016-080 <br />City of Santa Ana, officers, agents, employees, and volunteers, PWA - Transportation & Traffic Engineering Department are included as additional <br />insured (except for Workers Compensation) where required by written contract. Waiver of Subrogation is applicable in favor of City of Santa Ana, PWA <br />Transportation & Traffic Engineering Department on the General Liability, Auto Liability, Umbrella Liability, and Workers Compensation where required <br />by written contract.. COncellaffors clause is amended to 30 day except for 10 day notice of cancellation for non-payment of premium per policy <br />provisions. This Insurance is primary/noncontributory on the General Liability policy for the additional insured when such liability accrues from an act or <br />omisslon of the named insured on tho policy. <br />L;tK I II-IUA I t HULUtK L.AIYLCLLA I IUIV <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <br />By RISK MANAGEMENT DIVISION <br />lvSP 509 <br />FRAN-� <br />CINE R. VILLAREAL <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 />AUTHORIZED REPRESENTATIVE <br />Matt Rush <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />S135I199 1 19-18 GL AU Uinb WC $2M Professional I Matt Hush 19/2S/2019 1:S'/:31 PM (CDT) I Page 1 of 2 <br />