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® <br />A o CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DD/YYYY) <br />09/22/2017 <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Aon Risk Insurance Services West, Inc. <br />Los Angeles CA office <br />CONTACT <br />NAME: <br />PHONE (866) 283-7122 F'O'X (800) 363-0105 <br />(AIC. No. Ext): (A C. No.): <br />707 Wilshire Boulevard <br />suite 2600 <br />E-MAIL <br />ADDRESS: <br />LOS Angeles CA 90017-0460 USA <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURED <br />INSURERA: National Union Fire Ins Co of Pittsburgh 19445 <br />Tetra Tech, Inc. (IEW) <br />17885 VOA Karman Ave., suite 500 <br />Irvine CA 92614 USA <br />INSURER B: AIG Europe Limited AA1120841 <br />INSURER C: The Insurance Co oT the State Of PA 19429 <br />INSURERD: American Home Assurance Co. 19380 <br />INSURERE: Lexington Insurance Company 119437 <br />INSURER F: <br />C:UVtKAULb ULKIIHUAlt NUMBLK: b/UUbbbUJ944 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 />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. Limits shown are as requested <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />MMIDDIYYYY <br />MM/DD <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />Attn:Brian Ige <br />220 South Daisy Avenue <br />GL <br />2 <br />Santa Ana CA 92702 USA <br />EACH OCCURRENCE S2,000,000 <br />_I� <br />�4 �!G <br />CLAIMS-MADEX❑OCCUR <br />$1,000,000 <br />PREMISES Ea occurrence <br />MED EXP (Any one person) $10,000 <br />X X,C,U Coverage <br />PERSONAL&ADV INJURY $2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />GENERAL AGGREGATE $4,000,000 <br />POLICY M PRO FX] LOC <br />JECT <br />PRODUCTS - COMP/OPAGG $4,000,000 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />CA 428-80-55 <br />10/01/2017 <br />10/01/2018 <br />COMBINED SINGLE LIMIT $2,000,000 <br />Ea accident <br />BODILY INJURY ( Per person) <br />X ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIREDAUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Peraccident <br />X ISO Policy Form CA <br />B <br />X UMBRELLALIAB <br />OCCUR <br />CSUSA1702199 <br />10/01/2017 <br />10/01/2018 <br />EACH OCCURRENCE $11000,000 <br />EXCESS LIAB <br />HX <br />CLAIMS -MADE <br />AGGREGATE $1,000,000 <br />DED I X RETENTION 8101, 000 <br />C <br />D <br />C <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILRY YIN <br />OFFICER/MEM ERAN PR PRIETOR /EXCLUDED7EXECUTIVE f9 <br />(Mandatory in NH) <br />NIA <br />wc014629496 <br />wc014629497 <br />WC014629498 <br />wc014629499 <br />10/01/2017 <br />10/01/2017 <br />10/01/2017 <br />10/01/201710/01/2018 <br />10/01/2018 <br />10/01/2018 <br />10/01/2018 <br />XPER OTH- <br />STATUTEEli <br />E.L. EACH ACCIDENT $1,000,000 <br />E.L. DISEASE -EA EMPLOYEE $1,000,000 <br />If yes, describe Under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $1,000,000 <br />E <br />Env Contr Prof <br />028182375 <br />10/01/2017 <br />10/01/2019 <br />Each Claim $1,000,000 <br />Prof/Poll Liab <br />Agggregate $1,000,000 <br />SIR applies per policy ter <br />s 6 condi <br />ions <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />RE: Contract No. A2014-129-02, on -Call water Resource Engineering Services. City of Santa Ana, its officers, employees, agents, <br />volunteers and representatives included Additional Insured in <br />are as accordance with the policy provisions of the General <br />Liability policy as required by written contract. General Liability policy evidenced herein is Primary and Non -Contributory to <br />other insurance available to Certificate Holder, but only in accordance With the policy's provisions as required by written <br />contract. A waiver of Subrogation is granted in favor of City of Santa Ana in accordance wi the policy provisions of the <br />General Liability, Automobile Liability, Umbrella Liability and workers' Compensation pol' i as required by written contract. <br />Stop Gap coverage for the following states: OH, ND, WA, WY. <br />REVIEWED BY: EUNICE HEREDIA (PG I OF) ) <br />CERTIFICATE HOLDER <br />CANCELLATION Y <br />ACORD 25 (2016/03) <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE <br />CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />City Of Santa Ana <br />AUTHORIZED REPRESENTATIVE <br />Public works Agency <br />Attn:Brian Ige <br />220 South Daisy Avenue <br />� <br />2 <br />Santa Ana CA 92702 USA <br />r✓9tQ�la9tCG � <br />_I� <br />�4 �!G <br />ACORD 25 (2016/03) <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />