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WKEINCO-01 AUSTINA
<br />.I tlC"R®"
<br />`,,,_,.,- CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDD/YYYY)
<br />10/3/2018
<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 License # OE67768
<br />IOA Insurance Services
<br />4370 La Jolla Village Drive
<br />Suite 600
<br />CONTACT All Smith
<br />PHONE FAX
<br />(AIC, Ne, Ext): (619) 788-5795 50206 Arc, No:(619) 574-6288
<br />AIL
<br />ADDRESS: Ali.Smith@ioausa.com
<br />San Diego, CA 92122
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: RLI Insurance Coinpany
<br />13056
<br />INSURED
<br />INSURER B: Lexington Insurance Company
<br />19437
<br />INSURER C:
<br />10/1112018
<br />WKE, Inc.
<br />INSURER D:
<br />NSURERE;
<br />[,,INSURER
<br />X Cont Liab/Sev of Int
<br />400 N. Tustin Ave., #275
<br />Santa Ana, CA 92705
<br />F :
<br />— -- -
<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 />- -
<br />INSR
<br />LTRTYPE
<br />-- - - -
<br />OF INSURANCE
<br />ADDL
<br />SUBR-
<br />---- -
<br />POLICY NUMBER
<br />POLICY EPF
<br />PO IGY EXp — - - " (MMI olyyyy):LIMITS - - -- ---
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE 2,000, 00
<br />CLAIMS -MADE rrX OCCUR
<br />l_.
<br />X
<br />X
<br />PSB0001783
<br />10/1112018
<br />DAMAGE Tq RENTED 1,000 O
<br />10/11/2019 PREMI$$.S (Ea.:scc�rxen�a)_._,. $ 00
<br />X Cont Liab/Sev of Int
<br />MED EXP (Any one person)_ $ 10,000
<br />X BFPD
<br />PERSONAL &_ADV INJURY $ 2,000,000
<br />------ ___ ____
<br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL
<br />0
<br />AGGREGATE 4,000,000
<br />PRO-
<br />._�$-
<br />4,000,000
<br />POLICY JECT LOC
<br />HA
<br />PRODUCTS • COMP/OP AG G _$
<br />- -
<br />OTHER;
<br />;Decluctibie $ 0
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT 2,000,000
<br />'000 000
<br />LEa..accidant� ----$ - - -----
<br />--
<br />ANY AUTO
<br />PSB0001793
<br />110/11/2018
<br />10/11/2019 BODIIY_INJURY(Perperson$.-..._-._-__.___,_-_
<br />OWNED SCHEDULED
<br />..............._,
<br />1XX
<br />AUTOS ONLY /``Up7N0oSyy
<br />INJUpRY.(Per
<br />p
<br />AUTOS ONLY AUTOS ONY
<br />p130DILY
<br />- ---
<br />(Fera cident)._AMAGEAutos'
<br />Owned
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X OCCUR
<br />EACH OCCURRENCE --$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />PSE0001694
<br />10/11/2018
<br />10111/2019 5,000,000
<br />AGGREGATE-----...------'-_$----_....__-..__._-.—..-------------
<br />DED RETENTION
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />X P R OTH-
<br />. -$ ATUTE.-� LER_ -
<br />Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />X
<br />PSW0001614
<br />10111/2018
<br />10/11/2019 00
<br />E L._EACM ACCIDENT $ 1,000,000
<br />O FICE M MBE EXCLUDEb7 I
<br />pp E
<br />(Manda Ory In NH)
<br />NIA
<br />-_._ _
<br />1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - EA EMPLOYEE $
<br />— -r- — - --"-
<br />. E,L. DISEASE -POLICY LIMIT 1 $_ 1,000,000
<br />B
<br />Prof Liab/Clms Made
<br />035713747
<br />07/06/2018
<br />07/06/2019 'Per Claim 5,000,000
<br />B
<br />Ded.: $25K Per Claim
<br />035713747
<br />j 07/0612018
<br />i
<br />i
<br />07/06!2019 Aggregate 5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Re: Fairview Ave Bridge at Santa Ana River, Agreement No. A-2014-248 and A-2017-262
<br />City of Santa Ana, its officers, agents, volunteers and employees are Additional Insureds with respect to General Liability per the attached endorsement as
<br />required by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to General Liability and Workers' Compensation.
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium In accordance with the policy provi ions.
<br />REVIEWED B3 EUNICE HEREDIA (PG 1 OF )
<br />City of Santa Ana
<br />Attn: Mindy Ly
<br />20 Civic Center Plaza
<br />Ross Annex (M-361
<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 PROVISIONS.
<br />AUTHORIZED -S-REPRESENTATIVE
<br />_T_ AIS , 146W&a
<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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