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A� b® CERTIFICATE OF LIABILITY INSURANCE
<br />7/20/2017°""
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />MHBT, a Marsh & McLennan Agency, LLC company
<br />8144 Walnut HIII Lane, 16th FI
<br />Dallas TX 75231
<br />CONTACT Stacy Brimer
<br />NAME,872.770-1638
<br />FAX . 972-376-8108
<br />-MAIL81C,
<br />stacy_ , brimer@ m mhbt.co
<br />INSURERS AFFORDING COVERAGE NAIC0
<br />A
<br />INSURER A: Hartford Casualty Insurance Company 29424
<br />INSURED HUITTZOL
<br />INSURER e;Federallnsurance0 TpaU20281
<br />Huitt-Zollars, Inc.
<br />1717 McKinney Ave., Ste. 1400
<br />Dallas TX 75202-1236
<br />INSURER C:
<br />INSURER 0
<br />INSURER E:
<br />DAMAGE TO RENTE
<br />PREMISES em
<br />I SURER P:
<br />MED EXP (Any one person)
<br />COVFRAGFR CFRTIFICATF NIIMRFR- Ib4'159Z519 - RC\r14V1$I NIIH010co.
<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 />Representatives
<br />/LTR
<br />TYPE OF INSURANCE
<br />Santa Ana CA 97201
<br />POLICY NUM08R
<br />P pp. V Y
<br />M POLIC I
<br />LIMITS
<br />A
<br />TCOMMERCIAL GENERAL LIABILITY
<br />CLAIM&MAGE OCCUR
<br />4000NLJ3272
<br />6/112017
<br />61112018
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMAGE TO RENTE
<br />PREMISES em
<br />—
<br />$300,000
<br />MED EXP (Any one person)
<br />$10,000
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY jE0 � LCC
<br />GENERAL AGGREGATE
<br />$2„000,000
<br />PRODUCTS. COMP/OP AGO
<br />$2,000,OCO EE
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />4BUENPBO920
<br />6/112017
<br />611/2018
<br />Ea eccidentl____
<br />$1,000,000
<br />X
<br />ANYAUTO
<br />BODILY INJURY (P., person)
<br />$
<br />X
<br />3q
<br />AUTOS NEO AUTO6ULED
<br />HIRED AUTOS X NNON-OWNED
<br />AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PR PRT DAMAGE
<br />Per accident
<br />$
<br />X
<br />Coll $1,000 X Comp $1,000
<br />$
<br />A
<br />X
<br />UMBRELLA LIAR
<br />X
<br />gCCUft
<br />46XHURJ8271
<br />6/112017
<br />611/2018
<br />EACH OCCURRENCE
<br />$10,000,000
<br />EXCESS LIAR
<br />CIAIMS.MAOE
<br />AGGREGATE
<br />$10,000,000
<br />DED X RETENTION$ 10,000
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />OFFICERIMEMBER 6XCLUAEA7 ECUTIVE
<br />NIA
<br />0.6WEA04105
<br />6/112017
<br />8/1/2018
<br />X g ERH
<br />E.L, EACH ACCIDENT
<br />_
<br />$1000,000
<br />E.L. DISEASE. EA EMPLOYE-
<br />$1000,000
<br />I—------
<br />(Mandatory In NMI
<br />If YYee deemibe under
<br />0 SCRIPTION OF OPERATIONS be low
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />A Hired Car Physical Dam; $100,000 46UENP00920 61112017 a1112018
<br />B Employee Theft 82241608 8/1/2017 811/2016
<br />A Valuable Papers 46UUNLJ3272 6/1/2017 6/ 2018
<br />Hired PD Comp/Coll
<br />Employee Theft
<br />Valuable Papers
<br />Dad $1,0001$1,000
<br />Limit;$1,000,
<br />Limit: $25,000
<br />REVIEWED BY_ - -
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (gCORD 101, Addlllonal Ram ---�-^ -
<br />RI,NICE HEREDIA(PG
<br />OP
<br />Additional Insured form #HG0001 edition 06/05 applies to the General Liability Policy.
<br />Waiver of subrogation form #CG2404 edition 05/09 applles to the General Liability policy.
<br />Primary & Non -Contributory General Liability form #H 0001 edition 06/05.0
<br />Additional Insured form #HA9916 edition 03/12 applies to the Automobile Liability Policy.
<br />Waiver of subrogation form #HA9916 edition 03/12 applies to the Automobile Liability policy.
<br />See Attached...
<br />W IVUU-ZU14 AOUKU OUKrVKA I ION, All rights reserved.
<br />ACORD 25 (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 Public Works Agency, its officers,
<br />employees, agents, Volunteers and
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Representatives
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 97201
<br />W IVUU-ZU14 AOUKU OUKrVKA I ION, All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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