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II TRENV-01
<br />IRI ISCPI 1
<br />acoez® CERTIFICATE OF LIABILITY INSURANCE
<br />Cr1VPRARFSt CFRTIFI(:ATF NIIMRFR• 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.
<br />DATE 9/2 01 6
<br />12/29/2016
<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(les) 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
<br />Roger Stone Insurance Agency
<br />5015 Birch Street
<br />CONT
<br />PHONE FAX
<br />AIC, Ne, E4): (949) 757.0270 Aid, Nc):(949) 757-0375
<br />A2bmuA'LE$,,customerservice@stoneins.com
<br />Newport Beach, CA 92660
<br />INSURER(S) AFFORDING COVERAGE NAIC p
<br />11/10/2017
<br />INSURER A: Admiral Insurance Co. 24656
<br />DAEMGEETORENTED nCe 50,000
<br />INSURED
<br />INSURER BIRepublic IndemnitCompany 22179
<br />INSURER C
<br />Ultrasystems Environmental Inc
<br />INSURER D:
<br />16431 Scientific Way
<br />Irvine, CA 92618
<br />INSURER E:
<br />INSURER F:
<br />HAUTOMOBILE LIABILITY
<br />ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY ANUUYIECW
<br />AIRTOS ONLY X AUTOS ONLY
<br />Cr1VPRARFSt CFRTIFI(:ATF NIIMRFR• 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.
<br />INSR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />JUM
<br />D
<br />POLICY NUMBER
<br />POLICYEFF
<br />DD
<br />POLICY EXP
<br />M D❑
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ®OCCUR
<br />X Contr Poll Liability
<br />X
<br />FEIECC1110704
<br />11/10/2016
<br />11/10/2017
<br />EACH OCCURRENCE $ 5,000,000
<br />DAEMGEETORENTED nCe 50,000
<br />MEO EXP An one arson 5'000
<br />PERSONAL &ADV INJURY $ 5,000,000
<br />GEHL AGGREGATE LIMIT APPLIES PER:
<br />X POLICY E jEOT D LOC
<br />OTHER:
<br />GENERALAGGREGATE $ 5'000'000
<br />PRODUCTS - COMP/OPAGG $ 5,000,000
<br />A
<br />HAUTOMOBILE LIABILITY
<br />ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY ANUUYIECW
<br />AIRTOS ONLY X AUTOS ONLY
<br />FEIECC1110704
<br />11/10/2016
<br />11110/2017
<br />EOegdNtleotSINGLE LIMIT $ 1,000,000
<br />BODILY INJURY Per ersan $
<br />BORRDILY INJURY Per accident $
<br />Pe�acclden�AMAGE $
<br />UMBRELLA LIAR
<br />EXCESS LIAB
<br />OCCUR
<br />CLAIMS -MADE
<br />EACH OCCURRENCE
<br />AGGREGATE $
<br />DED RETENTION$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR)PARTNERIEXECUTIVE YIN
<br />O0FFICERIMEMDER� EXCLUDED? �
<br />(Mantlatory in NN)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N/A
<br />16319314
<br />0910112016
<br />0910112017
<br />X I PEAT UTE OTRH-
<br />1,000,000
<br />E.L. EACH ACCIDENT $
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br />1000000
<br />E.L. DISEASE - POLICY LIMIT , ,
<br />A
<br />A
<br />Professional Liab
<br />Professional Liab
<br />FEIECC1110704
<br />FEIECC1110704
<br />11/1012016
<br />11/10/2016
<br />11/10/2017
<br />11/1012017
<br />Each Occurrence 5,000,000
<br />Aggregate 5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached If mere spat. Is mgdindi
<br />RE: On -Call Environmental Services
<br />he City of Santa Ana, Its officers, employees, agents, volunteers and representatives are named Additional Insured as respects General Liability
<br />per form ECC -319.0712 attached. Insurance is primary/non-contributory per form ECC -548-0712 attached.
<br />✓6W -
<br />City of Santa Ana
<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 />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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