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ZIMINDU-01 CHANSEN
<br />iC"R"r
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDNYYY)
<br />3/1/2016
<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 certificate holder is an ADDITIONAL INSURED; the policy(ies) 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 />CONTACT Tracy Dolan
<br />Sacramento-Alllant Insurance Services, Inc.
<br />PHONE //916 643-2729 FAX
<br />Afe Me Ekl o l ) ac No : (916) 643-2723
<br />2180 Harvard St Ste 460
<br />Sacramento, CA 95815
<br />AIL
<br />ADDRESS: tracy.dolan@alliant.com
<br />INSURER($) AFFORDING COVERAGE NAIC#
<br />INSURERA:Zurlch American Insurance Company 1663E
<br />INSURED
<br />INSURER 8: Fireman's Fund Insurance Company '21873
<br />INSURER C:Aspen American Insurance Company i43460
<br />Zim Industries, Inc.; Bakersfield Well & Pump Co.
<br />INSURER D:
<br />4545 E Lincoln Ave
<br />Fresno, CA 93725
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 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 ISSUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR ADD $UaRr POLICYEFF POLICY EXP
<br />LTR TYPE OF INSURANCE INSD WVD _ POLICY NUMBER (MMIDDIYYYY) POLICY
<br />LIMITS
<br />A X�COMMERGIAL GENERAL LIABILITY EACH OCCURRENCE �$ 1,000,600
<br />CLAIMS MADE X DAMAGE TO Dr.rNED OCCUR X GL08311662-12 03/0112016 03/0112017 �$ 100,000
<br />PREMISES(EN occurrence)
<br />MED EXP (Anyone person) `$ 10,000
<br />IXEmployee BeOefltsLl ! PERSONAL &ADV INJURY '$ 1,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER: j GENERAL AGGREGATE I$ 2,000,000
<br />POLICY l.X ] JECT _ I LOO PRODUCTS - COMPIOP AGG $ 2,000,000
<br />OTHER: $
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLL L IMIT
<br />(Ea arad nt)_
<br />S 1,000,000
<br />A
<br />X
<br />ANY AUTO
<br />IBAP8311663.12
<br />103101/2016
<br />03/01120171
<br />Br1Dn. Y INJURY (Per person)
<br />_
<br />$
<br />L
<br />ALL OWNED i —r SCHEDULED
<br />AUTOS .__:AUTOS
<br />BODILY INJURY (Par accident)
<br />$
<br />..
<br />FARED AUTOS _ NON-OWNCD
<br />-AUTOS
<br />PROPERTY DAMAGE
<br />(Per accident)„
<br />$
<br />$
<br />X
<br />UMBRELLA LIAB OCCUR
<br />EACH OCCURRENCE_
<br />$ 9,000,000
<br />B
<br />EXCESS LIAB
<br />i CLAIMS-MFlDE
<br />i
<br />SSE 24507378
<br />03/01/2016
<br />03/01/2017
<br />AGGREGATE
<br />$ 9,000,066
<br />DED RETENTION$
<br />$
<br />_
<br />WORKERS COMPENSATION
<br />PER OTFI-
<br />X
<br />AND EMPLOYERS' LIABILITY
<br />_
<br />_STATUTE ERYIN
<br />A
<br />ANY PROPRIETOWPARTNEWEXECUTIVE
<br />NIA
<br />WC8311661.12
<br />03/01/2016
<br />03/01/2017
<br />EL EACH ACCIDENT $ 1,000,000
<br />OFFICERIMEMSER EXCLUDED?
<br />(Mandatory in NH) ',
<br />- - -
<br />E L DISEASE - EA EMPLOYEES $ 1,000,000
<br />If yes, describe untler
<br />DESCRIPTION OFOPERA_TIONS below
<br />_
<br />(EL. DISEASE -POLICY LIMIT 1,000,000
<br />_ _I_
<br />_
<br />j$
<br />C
<br />;Equipment Floater
<br />IMAC95D616
<br />03/01/2016
<br />03/01/2017
<br />Inst./Builders Risk 1,000,000
<br />C
<br />jEquipment Floater
<br />IMAC95D516
<br />( 03/01/2016
<br />03/01/2017
<br />RBL $100,000 ; Schad 17,277,150
<br />DESCRIPTION OF OPERATIONS i LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana, Its officers, employees, agents, volunteers and representatives are Additional Insured on the General Liability policy per the form attached.
<br />Primary and non-contributory wording applies.
<br />City of Santa Ana
<br />PWA, Water Resources
<br />220 S. Daisy Avenue (M-85)
<br />Santa Ana, CA 92703
<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 />01988.2014 ACORD CORPORATION.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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