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PAULUS ENG JLOF
<br />, ` �► CERTIFICATE OF LIABILITY INSURANCE C4AtElMM11lDlMYYYI
<br />-^ 0510212017'
<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 IBY 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 endorsoment(s).
<br />PRODUCER
<br />NAME:
<br />THE BROKERAGE COMMERCIAL INSURANCE SERVICES, Inc.
<br />PHONE
<br />(AtC (949) 2$7-5677._—
<br />20261 SW ,Acacia St., Suite 200
<br />No, EXt): .............
<br />Newport Beach, CA 92660
<br />a oriLss:
<br />-_INPyRERIS)„AFFORDING COVERAGE - _...._NAIc#
<br />....__- - .... ................... _ ........,
<br />INSURER A: Executive Risk Indemnity, Inc.
<br />INSURED
<br />INSURER. B : Federal Insurance Company 20281
<br />--
<br />Paulus Engineering, Inc.
<br />INSURER
<br />2871 E. Coronado Street
<br />INSURER D
<br />Anaheim, CA 92806
<br />- _...,.._.. _ _ ._....
<br />INSURER E1E
<br />INSURER F ;.
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT', TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 'WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />tlLT R ........ ......ADDL SUBR. POLICY EFF POLICY EXP -_-_
<br />TYPE OF INSURANCE NSD WVD ....POLICY NUMBER .�� IDD,YYYY � LIMITS
<br />A
<br />,,1(. COMM'.ERCIALGENERALLIABILITY
<br />EACH OCCURRENCE
<br />S 1,000,000
<br />CLAIMS -MADE i( OCCUR
<br />L.
<br />X
<br />54303105
<br />05/0112017
<br />05/01/2018
<br />DAMAGE TO RENTEb
<br />PI3I=�1SES (E.2 occu�rence4_
<br />100,000
<br />S..
<br />i
<br />Ma EX'� IAny,ernepersonl.
<br />5,040..
<br />$
<br />__.
<br />Seas©pan a aov IN�uizv
<br />$ 1,000 000
<br />_
<br />GEN"LAGGREGATE LIWTAPPLIES PER:
<br />�
<br />i
<br />GENERALAGGREGATE_..
<br />$ 2,000000
<br />n POLICY PR(]- y LOC
<br />� 2,000 000
<br />JECT
<br />PRCDDUG75-CCMPdgPAGG'
<br />$ ,.....
<br />OTHER
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE. LIMIT
<br />Ea accident,,,.
<br />1,00'0.000
<br />_
<br />--
<br />ANY AUTO
<br />- --
<br />54303104
<br />05/01 /2017
<br />, 05101' 12018
<br />BODILY INJURY (Per Pems )
<br />$
<br />CW'NED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />1
<br />11
<br />BORILY INJURY (Per aoctidenC
<br />I S
<br />HIRED NON- WNED
<br />..
<br />PROPERTY DAMAGE
<br />_
<br />AUTOS ONLY AUTOS ONLY
<br />,_(Per,a�cldent) ..... ..-
<br />$ --
<br />i
<br />$
<br />UMBRELLA LIAR OCCUR
<br />'.I EACH (OCCURRENCE.
<br />$
<br />f
<br />EXCESS LIAB CLAIMS -MADE.
<br />AGGREGATE
<br />S
<br />._ .._......,.
<br />�
<br />C}ED RETENTI ON5
<br />S
<br />B
<br />WORKERS COMPENSATION
<br />-
<br />PER OTH.
<br />STATE ER
<br />-
<br />YIN
<br />_
<br />ACCIDENT..._.
<br />. ,.
<br />... 1,�%Q00f}�I'
<br />'$ '
<br />IANYPROPRIETORIPARTNERFEXECUITiVE
<br />OF�FIC RPM�MBER EXCBLILITY UDED?
<br />N r p,
<br />I
<br />A$0' 1d6
<br />0$10112017
<br />05101/2�if0
<br />,Mandatory in NH)
<br />If yes describe under
<br />L�ESCR#PTIr}N below
<br />E.IL. DISEASE
<br />�................. S ....... EA EMPLOYEE
<br />E$ 1 ,000,000
<br />$ .,,... .
<br />1,0..00,00.0
<br />C?F,OPERAI'IQNS
<br />__.._-, _
<br />-_...... .........._......
<br />E.L. DISEASE - POUCY LIMIT
<br />S ._
<br />DESCRIPTION OF OPERATIONS I LOCATIONS, VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached if more space is required) - -- --
<br />RE: Santa Ana Emergency Work. RE: Santa Ana Emergency Work.. glaip
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Named as Additional Insureds as respects General Liability per
<br />Attached Endorsement.
<br />This Insurance shall apply as Primary and Non -Contributory per attached endorsement.
<br />City of Santal Ana,
<br />220 S. Daisy Ave.,. M-85
<br />Santa Ana, CA 92702
<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 PRO7VISION'S.
<br />AUTHORIZED REPRESENTATIVE
<br />11/9/17, Page 1 of 5
<br />ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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