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<br />ACORDT,, CERTIFICATE OF LIABILITY INSURANCE
<br />COVERAGES
<br />DATE(MM/DD/YYYY)
<br />10/07/2017
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Greyling Ins. Brokerage/EPIC
<br />3780 Mansell Road, Suite 370
<br />Alpharetta, GA 30022
<br />NAMEACT Jerry Noyola
<br />PHONE F
<br />A/C No Ext : 770-552-4225 A/C, No); 866-550-4082
<br />E-MAIL
<br />ADDRESS: lerry.noyoia@greyling.com
<br />INSURER(S) AFFORDING COVERAGE NAIC it
<br />INSURER A: National Union Fire Ins. Co. 19445
<br />GL6268336 _:
<br />INSURED ,.. -
<br />' � -
<br />KPFF, Inc.
<br />1601 5th Avenue
<br />irtsuRER B: Continental Insurance Company 35289
<br />INSURER 0: Lloyds of London
<br />��.y��
<br />CLAIMS -MADE i +a OCCUR
<br />Sulte "1600
<br />INSURER D
<br />INSURER E f
<br />A 98101"
<br />Seattle, WA-98101-
<br />pp NN
<br />PR- I Eaoccur n e - $500,000_,
<br />u, COVERAGES _ CERTIFICATE NUMBER! 17«1A
<br />RFVISICIN NIIMRFR! - -
<br />THIS IS TO CERTIFY THAT THE PCLICISS OF INSURANCE LISPED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOp
<br />-INDICATED; NOTWITHSTANDING ANY -REQUIREMENT, TERM OR CONDITION Or ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS -
<br />='CEFMFICATE MAY gE�ISSUED'OR MAY�PERTAIN; THE1NSURANOE AFFORDED BY THE POLICIES DESCRIBED HEREINISSUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS -AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN. MAY HAVE BEEN REDUCED BY PAIL) CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />I I
<br />R
<br />POLICY N MBER
<br />P L
<br />I
<br />P Li Yy E p
<br />/D IY Y LIMITS
<br />A
<br />(=COM(uf,ERCIALGENERALLIA61LfTY
<br />GL6268336 _:
<br />10/10/2017
<br />04/0`1/201 EACH OCCURRENCE $1.000.000
<br />��.y��
<br />CLAIMS -MADE i +a OCCUR
<br />pp NN
<br />PR- I Eaoccur n e - $500,000_,
<br />X Contractual Liab.
<br />MED EXP (Any one person)_ $2$ 000
<br />PERSONAL & ADV INJURY $1,000,009
<br />GEN'LAGGREGATELIMITAPPLIES PER;
<br />GENERALAGGREGATE $2,000000
<br />-POLICY JECT LOC:
<br />PRODUCTS • OOMPIOP AGO $2,000,000
<br />OTHER:
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY, _
<br />CA9775930
<br />10/10/2017
<br />04/01/201 C a a ciden INLIMIT'$1,000,000
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Perperson) $
<br />ALL OWNED SUCH8DDULED
<br />AUTOS NON•(SWNEC)
<br />BODILY INJURY (Per accident) $
<br />HIRED AUTOS AUTOS
<br />p OPERT OA'AG'
<br />Pera
<br />r ident $
<br />$
<br />B
<br />X
<br />UMBRELLA LIAB
<br />OCCUR
<br />6050399824
<br />10/10/2017
<br />04/01/201 EACH OCCURRENCE $1-01000,090
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE $) 910091000 .
<br />DED X RETENTION$O
<br />A
<br />WORKERS COMPENSATION
<br />WCO22298246 (AOS)
<br />`
<br />10/10/20'17
<br />04/01/201 X p R H.
<br />AND EMPLOYERS' LIABILITY IN
<br />ANY PROPRIETOR/PARTNR/ xECUTIVE
<br />OFFIC R/MEMBEREXCLUU E9 nj
<br />N/A
<br />E.L. EACH ACCIDENT 0,00Q.000
<br />A
<br />(Mandatory In NH) --
<br />-
<br />WCO22298244 (CA)
<br />10/10/2017
<br />04/01/201 E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />If describe under
<br />DESCRIPTION OF OPERA I N low :
<br />E.L. DISEASE - POLICY LIMIT $1,0000000
<br />C
<br />Professional/ -' -
<br />80146LDUSA1704384
<br />10/10/2017
<br />10/10/201 Per Claim $10,000,000
<br />Pollution Liab. - ;
<br />-
<br />Aggregate $10,000,000
<br />Sufi $250,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additl0nal Remarks Schedule, may be attached If more apace Is required)
<br />Re: Contract #s -A-2015.175 & A-2016.135 - Engineering Consultant Agreement; KPFF Job #1600031. The City of
<br />Santa Ana, its officers, employees, agents & representatives are named as Additional Insureds with respects
<br />to General Liability where required by written contract. Should any of the above described policies be
<br />cancelled by the Issuing insurer before the expiration date thereof, 30 days' written notice (exc ,pt 10 days
<br />for nonpayment of premium) will be provided to the Certificate Hold r-
<br />REVIEWED BY: EUNICE 1lEREDIA (PG of )
<br />City Of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Clerk of the City Council ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza (M-30)
<br />P.O. BOX 1988 AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702.1988 vow.
<br />01988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S874982/M874944 JNOY1
<br />
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