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ACOR 7 a
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />9/26/2018
<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 />Asero Insurance Services
<br />200 N. Almaden Blvd. 3rd Floor
<br />San Jose, CA 95110_(AJC,
<br />CONTPRODUCER
<br />NAME: Asero Insurance Services
<br />PHONE FAX
<br />IC No).. 408-271-1802
<br />Ext): 866-966-8928 AIC'
<br />�o
<br />ADDRESS: cents@aseroins.com
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />CP03069506-00
<br />INSURER A: Zurich American Insurance Company 16535
<br />www.aseroins.com License No. OA91339
<br />INSURED
<br />Mark Thomas & Company Inc.
<br />2290 North First Street, Suite 304
<br />INSURER B: American Guarantee and Liability Ins Co 26247
<br />INSURER C:
<br />INSURER D:
<br />San Jose CA 95131
<br />INSURER E:
<br />INSURER F:
<br />D AGE R TED
<br />PREMISES Ea occurrence $1,000,000
<br />COVERAGES CERTIFICATE NUMBER: 44284471 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 />ILTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />S fVDR
<br />POLICY NUMBER
<br />MMIDDIYEYYY
<br />MM/DCNY
<br />LIMITS
<br />A
<br />,� COMMERCIAL GENERAL LIABILITY
<br />✓
<br />,/
<br />CP03069506-00
<br />9/15/2018
<br />9/15/2019
<br />EACH OCCURRENCE $1,000,000
<br />CLAIMS -MADE � OCCUR
<br />D AGE R TED
<br />PREMISES Ea occurrence $1,000,000
<br />MED EXP (Any one person) $10,000
<br />PERSONAL & ADV INJURY $1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $ 2,000,000
<br />POLICY PE� � LOC
<br />PRODUCTS - COMP/OP AGG $2,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />CP03069506-00
<br />9/15/2018
<br />9/15/2019
<br />Ea aBINdEeDtSINGLE LIMIT $1,000,000
<br />BODILY INJURY (Per person) $
<br />✓
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident) $
<br />✓
<br />AUTOS ONLY ✓ AUTOS ONLRED NON-OWNEDY
<br />Parr accdenDAMAGE $
<br />Comp/Coll Ded: $1,000 $
<br />B
<br />/ UMBRELLA LIAB f OCCUR
<br />AUC3254206-00
<br />9/15/2018
<br />9/15/2019
<br />EACH OCCURRENCE $4000,000
<br />EXCESS LIAB CLAIMS -MADE
<br />AGGREGATE $4,000,000
<br />$
<br />DED I I RETENTION $
<br />I
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />�/
<br />WC3069507-00
<br />9/15/2018
<br />9/15/2019�/
<br />STATUTE ERH
<br />E.L. EACH ACCIDENT $1,000,000
<br />OFFICERIMEMBER EXCLUDED? ❑N
<br />/ A
<br />E.L. DISEASE - EA EMPLOYEE $ j
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />I
<br />I
<br />E.L. DISEASE - POLICY LIMIT $ 1 000 000
<br />A
<br />Rented/Leased Equipment
<br />CP03069506-00
<br />9/15/2018
<br />9/15/2019
<br />Per Item Limit: $10,000
<br />Per Occurrence Limit: $100,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />Job #IR -15103 On -Call Engineering Services - Agreements (A-2015-173; A-2018-159-07)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives
<br />NOTE: 30 DAYS NOTICE OF CANCELLATION WILL BE GIVEN EXCEPT 10 DAYS FOR NON-PAYMENT.
<br />REVIEWED BY: EUNICE HEREDIA (PG OF 1d
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />20 Civic Center Plaza
<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 PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Joe
<br />Y
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<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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