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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIODIYYYY)
<br />12I29I2016
<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.
<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 />Central, Inc.
<br />Aon Risk services Office
<br />Pittsburgh Office
<br />CONTACT
<br />NAME:
<br />PHO (8661 203-7122 FAX(800) 363-0105
<br />AIC. No. Ext): INC,IMONaO:
<br />E-MAIL
<br />ADDRESS;
<br />we
<br />625 Lion ty Av ueth Floor
<br />625 Liberty Avenue
<br />INSURER(S) AFFORDING COVERAGE NAIL N
<br />Pittsburgh PA 15222-3110 USA
<br />INSURED mmu—
<br />INSURER A: Liberty mutual Fire ins Ce 123035
<br />Michael Baker International, Inc.
<br />Formerly Pacific Municipal
<br />consultants Come)
<br />INSURER e: Liberty Insurance Corporation 42404
<br />INSURER Cr National Union Fire Ins CO of Pittsburgh 19445
<br />INSURER Lloyd's Syndicate No. 2623 AA1128623
<br />2729 Prospect Park Drive, Suite 220
<br />Rancho Cordova CA 95670 USA
<br />INSURER E:
<br />INSURER F1
<br />COVERAGES CERTIFICATE NUMBER: 570065040044 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 />LT
<br />TYPE OF INSURANCE
<br />INSo
<br />MND
<br />POLICY NUMBER
<br />MMIDDIWYYI
<br />RAIMMOPYYYYMCOMP'OP
<br />LIMITS
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<br />� 6b2Y.evs9
<br />X COMMERCIAL GENERAL LIABILITY
<br />T62 $ 00414571
<br />74
<br />, !-
<br />URRENCE 82,000,000
<br />CLAIMS-MADE ❑X OCCUP.
<br />oRENTEG—... ..—......._..._-.—
<br />Ea ocou,mnc
<br />,$1,000,000
<br />Ar'00e Person) $5,000
<br />L 3 AGO INJURY $2,000,000
<br />GENT AGGREGATE LIMN r APPLIES PER
<br />AGGREGATE 54,000,000
<br />PULIC'! �PRo � LOC
<br />S-COMPIOP AGGIECYLA
<br />AUTOMOBILE UABILnY
<br />AS2-631-004145-726
<br />08/30/2016
<br />08/30/2017Immg
<br />GLE LIMIT$2,000,000
<br />Ea
<br />BODILY INJURY (Par peon)
<br />X ANY AUTO
<br />BODILY INJURY (Per D,,clen)
<br />OPINED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED.PVYoa NON.O VIED
<br />PROPERTY DAMAGE
<br />CNLY AUTOS ONLY
<br />Peraccltlent
<br />C
<br />X
<br />I UMBRELLAUAB
<br />X
<br />OCCUR
<br />BE060476715
<br />08/30/Z016
<br />08/30/2017
<br />EACHCOCURRENCE $10,000,000
<br />AGGREGATE $10,000,000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DED %
<br />RETEPITIDpl iln, ono
<br />B
<br />WORKERS COMPENSATION AND
<br />WA768D004145776
<br />08/ /201
<br />�, 321
<br />x oEP. OTH-
<br />STATUTE ER
<br />EMPLOYERS' LIABILITY YIN
<br />AOS
<br />E.L EACH ACCIDENT $1,000,006
<br />D
<br />PFA' PROPRIETOR I PARTNER I EXECUTIVE
<br />rl
<br />NIA
<br />WC768100414$786
<br />08/30/i016
<br />68/36/2517
<br />OFFICEWMEMBER E%CWOEPt
<br />(Ma m.ml In NHS
<br />WI
<br />E.L OISEASEEA EMPLOYEE $1,000,000
<br />"yes, descdbsUnder
<br />DESCRIPTION 05OPER.ATIONS below
<br />[. L. DISEASE -POLICY $1,000,000
<br />0
<br />E&O-PL-Primary
<br />gC1602675
<br />58/31/2016
<br />08/31/2017
<br />Per Claim $5,000,000
<br />Professional & Pollution
<br />Aggregate $5,000,000
<br />SSR applies per policy teres
<br />& condi
<br />ions
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACDRD 101, Additional Remalke Schedule, may be aaached if more space is required)
<br />For ,Named Insured Only' Attn: Pam warfleld. RE Project Name: on-call Environmental Services. City of Santa Ana, its
<br />officers, emplo�eas and designated Volunteers are included as Additional Insured in accordance with the policy provisions of
<br />n
<br />the Geeral LTa ility Policy. Should General Liability, Automobile Liahi1l ty, Professional Liability and workers' Compensation
<br />policies be cancelled before the expiration date thereof, the policy provisions will govern how notice Of cancellation may be
<br />delivered to certificate holders in accordance withthe Policy provisions,
<br />CERTIFICATE HOLDER
<br />CANCELLyATION I/ L--
<br />Q1980-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (20161)3) The ACDRD name and Ingo are registered marks of ACORD
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE
<br />DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City Of Santa Ana
<br />Ater. Clerk of the City Council
<br />AUTHORIZED REPRESENTATIVE
<br />v�
<br />20 Civic Center Plaza (M-30)
<br />Santa nna R 92702 USA
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<br />G�L�Ib p��
<br />Q1980-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (20161)3) The ACDRD name and Ingo are registered marks of ACORD
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