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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 />