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AC'Of2V CERTIFICATE OF LIABILITY INSURANCE
<br />OATS (MM DD YYYYI
<br />0/22/201
<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: It 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 center rights to the certificate holder in lieu of such endorsemant(s).
<br />PRODUCER Bolton & Company
<br />3475 E. Foothill Blvd., Suite 100
<br />Pasadena, CA 91107
<br />MEI
<br />PHONE �FA�----
<br />EMU (628) 799-7000 IAIc. Noh (626) 583.2117
<br />/NLD
<br />0 KESS:
<br />INSURERll AFFORDING COVERAGE NAICM
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MAGE F✓ OCCU2RE
<br />INSURERAI Greenwich Insurance Company 22322
<br />wo.w.bolton0o.com 0008309
<br />INSURED
<br />United Pumpingater, Inc. Service, Inc,
<br />United Storm W
<br />INSURER BI XL Insurance America Inc. 4664
<br />wsuRERc; xi.Specialty Insurance Company 37885
<br />INSUReao: Indian Harbor Insurance Company 36940
<br />4 Least Inc.
<br />14000 East Valley Blvd.
<br />City of Industry CA 91748
<br />INSURER E:
<br />INSURER P'
<br />CCVFRAn FR CFRTIFICATF MIIMRFR. aaaaacac RFVICInAl MIIMIRCR,
<br />THIS 1$ 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 />/NSR
<br />TYPE OFINSURANCE
<br />AUULla
<br />POuCYNUMBER
<br />elc F
<br />PCLIOY EXP
<br />12/3112017
<br />LIMITS
<br />A
<br />,/
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MAGE F✓ OCCU2RE
<br />✓
<br />GEC3001234
<br />12/31/2016
<br />EACHOCCURRENCE $ 11000,000
<br />IEEE RENTED ce $ 50,000
<br />✓
<br />MED EXP (Any oneperson) $ 5,000
<br />Properly Damage Ded $26,000
<br />.1J
<br />Bodily Injury [)ad $25,000
<br />PERSONAL&AOV INJURY & 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY L✓ IJJ08T1:1 LOC
<br />GENERAL AGGREGATE S 2,000,000
<br />PRODUCTS• COMPIOP AGG $ 2,000,000
<br />S
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />AECO048938
<br />1213112016
<br />12131/2017
<br />COMBINED SINGLE LIMIT §
<br />1000000
<br />V
<br />ANYAUTo
<br />AECO048939
<br />12/31/2016
<br />12131/2017
<br />__
<br />BODILY INJURY person) $
<br />✓
<br />OYVO HED
<br />AUTOS ONLY AUTOBULEO
<br />HIRED NON -OWNED
<br />AUTOS ONLY ✓ AUTOS ONLY
<br />BODILY INJURY (Per acesenn S
<br />ROPERTV DAMAGE
<br />Per eecid t $
<br />_
<br />Ded Comp & Collision $ 1,000
<br />C
<br />UMBRELLAUAS ✓ OCCUR
<br />UECO048940
<br />12/3112016
<br />12131/2017
<br />EACHOCCURRENCE $ 15000000
<br />AGGREGATE S 15,000,000
<br />✓
<br />E%GESS LIAa CIAIMS-MADE
<br />S
<br />DEO I ✓ I RETENTION 50
<br />B
<br />WORXERSCOMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANYPROPRIETOMPARTNEMEXECUTIVE YIN
<br />OFFICERIMEMBEREXCLUDEOP FNI
<br />NIA
<br />WEC3001235
<br />12131/2016
<br />12131/2017
<br />✓ STATUTE ETM
<br />E.L. EACH ACCIDENT 5 1,000,000
<br />sl., DISEASE - EA EMPLOYEE S 1000000
<br />SAIIn NN) -
<br />If yes,reorder, under
<br />OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />D
<br />Pollution Liability
<br />PE00048963
<br />12/31/2016
<br />12139/2017
<br />15,000,000 Each Claim ! $25,000 (Detl
<br />D
<br />Professional Llab - Claims Made
<br />PECO048963
<br />12/31/2018
<br />12131/2017
<br />15,000,000 Each CIBim 1$26,000 (Ded)
<br />DESCRIPTION GPOPERATIONSILOCATIONSIVENICLES (ACORD 01, Addlllonal Remarks Schedule, maybe aaached It mem space Is required)
<br />GL Additional Insured applies per CG20100413 & CG20370413 attached, only if required by written contraotlagreement.
<br />OL Primary & Non -Contributory Wording applies per XIL4240605 attached. Excess Pollcy follows form.
<br />Re! Project #16144.
<br />Additional Insured s): City of Santa Ana, Its officers, employees, agents, volunteers and representatives.
<br />REVIEWED BY- ..:. . . . ...:. EUINICE HERE[t/. F
<br />Cit of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20CivicCenter Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />I Cassandra Rosales
<br />©1988-2015 ACORD CORPORATION. All rights reserve
<br />ACORD 25 (2016163) The ACORD name and logo are registered marks of ACORD
<br />16298131 1 UNITPUN-OS I I6 -LI GL, Auto, Drab, VC, LOLL, Prof Liub I OoLmn CertLficute Ptoceaatn9 , 6/22/2017 l: CL 2" PH (PDT) I Pala t of 5
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