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AQ �a CERTIFICATE OF LIABILITY INSURANCE <br />DATA MMIDDIYYYY) <br />1 4/5/2017 <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 />ONTACT <br />Dealey, Renton & Associates <br />License #00207391AIQ <br />P. 0. Box 10550 <br />PHONE . 714-427-6810 FAX 714-427-6818 <br />t1.): <br />EMAIL rise@dealeyrenton.com <br />Santa Ana CA 92711-0550 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURERA:ACE American Insurance Company 22667 <br />INSURED PSOMAS <br />INSURER 9: <br />PSOMAS <br />555 South Flower Street, Suite 4300 <br />Los Angeles CA 90071 <br />INSURER C: <br />INSURER D ; <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATF NUMRFR- 1718609535 RFVICIPIN NIHMIRFR, <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 />IST R <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY <br />MID Y� <br />POLICY EXP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE LIOCCUR <br />EACH OCCURRENCE $ <br />DAMAPREM 0 NTED <br />PREMISES Ea occurrence $ <br />MED EXP (Any one person) $ <br />PERSONAL& AOV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />P 0 U c Y 7 PE Q 7 LOC <br />GENERAL AGGREGATE $ <br />PRODUCTS - GOMP/OP AGG $ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />MBINEDIN T $ <br />Ea accident <br />BODILY INJURY (Per person) $ <br />ANY AUTOgg <br />��{{ pp <br />AUTOS NED AUTOSULED <br />BODILY INJURY (Per accident) $ <br />HIRED AUTOS AUTOS NED <br />AUTOS <br />; <br />PROPERT DAMA <br />Per accident $ <br />UMBRELLA LIAB <br />OCCUR <br />1 <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />PER OTH. <br />SIMUTE E <br />E,L, EACH ACCIDENT $ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE ❑NIA <br />OFFICERIMEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYEE $ <br />(Mandatory in NH) <br />If yesdescribe under <br />DEnRiPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $ <br />A <br />Professional Liability <br />Claims Made <br />G23638381008 <br />10/15/2016 <br />10/15/2017 <br />Per Claim $1,000,000 <br />Annual Aggregate $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />30 Day Notice of Cancellation/10 Day notice for Non -Payment of Prem <br />2SAN051100, Agreement #A-2008-219 and #A-2015-167, City of Santa Ana On -Call Engineering Services 14-037, <br />REVIEWED BY: ""EUNIGE HEREDIA (PG OF6 ) <br />CERTIFICATE HOLDER CANCFI I_ATION <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana, PWA -Design Engineering <br />Attn: Monica M. Suter, PE, TE, PTOE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza, M-36 <br />Santa Ana CA 92702 <br />AU HORIZED REPRESENTATIVE <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD <br />