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WWOOLINJC-01 NIGONZAL
<br />DATE (MMIDDIYYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE 2/2612020
<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 />BELOWW., THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IINSURERjSj, AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holderis an ADDITIONAL INSURED, the policyjiesj must have ADDITIONAL. INSURED provisions or be endorsed.
<br />If SUIBROGATION 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 endorsements .
<br />PRODUCER C N AOT:
<br />times S Gough O _ ' Ax .�
<br />3300 Greensboro Drive, c rSq_ II 7i13 27 2277 (AIC, No) (7a ) $27 79
<br />Suite 980 adrnln(arrtesrauh cord
<br />VcLean„ VA 22102,-
<br />INSURED ^°" )f15,MffiEfS.O Trav l rs Prgp..rt Casualt rm ran of America
<br />WWoolpert Inc. it su Et(.. ggt nerr l . sualty �Q pl nylIW kIA.wXv-
<br />4d54 Idea Center Boulevard
<br />Dayton, OH 45430-1500 ....w._.__.._.._
<br />Q9Y9RAGES 9E911EIrATE 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, NOT"wIIFITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 />_...._.,.._.�... ._......._ ______.. _. w._. _ _. ._.-._,.. _.-.., _ -_,._ _ _.. .�.__..- __... . ._ --- ....,.... _....
<br />LTR ...,
<br />Ai7OL, SUBR:: POLICY EFF POLICY Ex.P
<br />UNSR TYPE OF INSURANCE ITU3•LICY NUMBER LIMITS
<br />A COMMERCIAL GENERAL LIABILITY
<br />�,�aH C:i4"Q"iIRRENCE ___ I 1
<br />IL .m....TO RENTED 30d000rE OCCUR X 3f1t33 3f1T2020 3l1/2d21CLAIMS-MADAMAGE
<br />X Contractual Liao. fir' 25 d00
<br />._. _... .. w._._..._ MEID Q) R (.Y e-g?arm) _ . ...... __...,-_m _ ..
<br />ER LNnL_&AC)VwL-LURY 1_.__.. 1,000,000:
<br />gJzNLAaaRrw,Q&lfLIMITAPPLES PER: 2,000,000
<br />POLICY �.-.!�� � �j �...,,�. lea I�aaa¢TV�Ts- ��MP"�E���,. ,`t..,.,�..,,�.� 2,000,000
<br />II
<br />A mAUTOMOBILE LIABILITY ^" C MMNNEG7 SINGLE I ]MIT _. 1,000,000
<br />X ANY AUTO 2446855 31112020 3P1f2021
<br />OWNED _ S'HEEDLULED
<br />'...... AUTOS ONLY AUTOS �p „�,'""'"' � �'""'� ,wD ". Y INJI�FCY QF's�q...�a atU2urtk �_,-...,..._..,..._.._....._
<br />AI4.UTa,S ONLY _ AUTO ' BL .1 cUn ARnIt6GE-... ,_..,...„____......................Y..._._.___..___:...
<br />LUM.BRELLALIAB X i OCCUR � �-,. e�NH....,.. �s.�u....._.... ,..� ...M _...1d 000 dd'd,:..,.
<br />X EXCESSLIARAMyµ ^ J __. CLkMS-MADE ZUP-31N10602-20-NF 311/2020 311/20,21 10,000„Q00
<br />DIEDXu RETENTIONS
<br />A WM'O�RKERS COMPENSATION PER I.'b"IP
<br />ANCa EMPLOYERS• LIABILITY
<br />_ .,"PIIATtiIL
<br />ANIY PR7PME1 ORMAR"I NERPEXECUJiTIVE 'Y..tB 1132 673 3,1112020 31112�021 1,000,000
<br />gFE'Cd. MIEIn NH) EXCL UEO'r N4 N I A
<br />l,�darerylr,NHg k I S?9L.._.F61LiU'IgLL .. _...... .... 1 iSdd,ildd
<br />de tY(IFlI(r 1,000,000
<br />If
<br />es, rUe'cr N. P...: FIxr QNS be] ow _.. U.. 6M6, .
<br />C Pro asional Liab. " EH2,II835507'2 311/2020 3/11202/ Per Claim/Aggregate 2,000,000
<br />DESCRIWTION Of OPERATIONS P LOCATIONS) VEHICLES (ACORD 101, Addifional Remarks SchodulUe, may Ibe atWched It morespace Is required)
<br />iRE; Project #78392
<br />The City of Santa Ana„ its officers, employees, agents„ volunteers and representatives are included as additional Insured with respect to General Liability �w
<br />when required by written contract.. General Liability Includes Additional Insured coverage for On -Going & Completed Operations as required by w 4tten
<br />contract. General Liability is primary and non-contributory over any existing Insurance and limited to liability arising out of the operations of the named
<br />Insured and when required by written contract. 3"ay Notice of Cancellation will be issued for the General Liability, Automobile Liability, Umbrella Liability,
<br />'Workers Compensation and Professional Liability policies in accordance wvIth policy terms and conditions,
<br />CgRI109AI9 HOLDER
<br />Ira Z AI"�IA(:gEM[,N"A VISiC)N
<br />w SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana 'Li ACCORDANCE, WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza (M-30)
<br />PO Box 1986 ...w,. �.�
<br />Santa Ana, CA 02702-1988 ANIIL: C°t'VE f� AUTHORIZED REPRESENTATIVE
<br />�r~~'�
<br />ACORD 25 (2016103) 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />WI°l
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