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APPLI.2 OF ID: KC
<br />AMe'W CERTIFICATE OF LIABILITY INSURANCE 001103/201 8
<br />01103!28
<br />THIS CERTIFICATE IS ISSUED AS A RAATTER 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 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 CONTACT
<br />NAME:
<br />Stockdale Ins (Bakersfield) PHO 6$1 843-1546 Ata, No): SBI 327 3490
<br />LICENSE #OC26131 KC No „EMI.;_
<br />PO Box 10269 ENTAIL _.r --^
<br />Bakersfield, CA 93389.0269 ADDRESS:
<br />Andy Naworski INSURERIS) AFFORDING COVERAGE NAIC N
<br />INSURERA: Federal Insurance Company 20281
<br />INSURED Applied Technology Group Inc. INSURER B: Insurance Co. of The West 27847
<br />4440 Easton Drive INSURER C;AGCS Marine Insurance Company' 22837
<br />Bakersfield, CA 93309
<br />INsuRERo:Scottsdale Insurance Company 41297
<br />INSURER E :
<br />INSURER F:
<br />Ce)VPPAGFS CFRTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFYTHAT 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
<br />THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB,iECT TO ALL THE
<br />TERMS,
<br />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS,
<br />City of Santa Ana its Officers
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />N TYPE OF INSURANCE POLICY EFF
<br />ILTR 0 POLICY NUMBER MMIDDIYYYY
<br />POLICY
<br />MMIDDIYYYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE $
<br />1,000,000
<br />A i( COMMERCIAL GENERAL LIABILITY Y 360252.22WCE 07/01/2017
<br />07/01/201$
<br />pREMISEs Ea occ FD nce $
<br />1,000,000
<br />CLAIMS -MADE FK OCCUR
<br />MED ESP (Any one person) $
<br />10,000
<br />'T Contractual
<br />PERSONAL S ADV INJURY $
<br />1,000,00
<br />GENERAL AGGREGATE $
<br />Z000,000
<br />GEN'L AGGRCGATELIMIT APPLIESPER'.
<br />PRODUCTS-COMWOPAGG $
<br />2,000,00
<br />1-1 POLICV X jRO, LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Eaacdden[ $
<br />1,000,000
<br />A X ANY AUTO (17)7358-4639 07/01/2017
<br />07/01/2018
<br />BODILY INJURY (Per parson) $
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per flocldent) $
<br />AUTOS AUTOS
<br />_.....
<br />NON -OWNED
<br />PROPERTY C-.4NlAGn,: $
<br />HIRED AUTOS AUTOS
<br />PER ACCIC�NP _
<br />K UMBRELLA LIAB X OCCUR
<br />EACH OCCURRENCF $
<br />5,000,000
<br />A EXCESS ILIAD CLAIMSMADE7989-48.22 07101/2017
<br />0710112018
<br />1 AGGREGATE $
<br />5,000,000
<br />_
<br />DED RETEN ION$ 1
<br />FOLLOWING $
<br />FORM
<br />WORKERS COMPENSATIONX
<br />WCSTATU. TH-
<br />TORY
<br />ANDEMPLOYERS'LIAS[UTY
<br />B ANY PRO IETOR1PAR'NER,A£IFCLMEYIN SA50361160 0312212017
<br />0312272098
<br />E.L. EACHaCeIGENr S
<br />1,000,0
<br />Oxindat ry In IN R EXCLUDER? N 7 A
<br />ybeird
<br />EL DISEASE - EA EMPLOYEE $
<br />110001000
<br />Teesdee
<br />Il yea describe antler
<br />I')ESCRIPTION OF OPER AI'IONS below
<br />EL. DISEASEPOLICYLIMIT $
<br />1,000,000
<br />C Equipment Floater SM L93032865 071011201770-T0112098
<br />Towers
<br />1,531,000
<br />D Professional EKS3237775 11/191201/19/2018
<br />Per Claim
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES (Attach ACORD 101, Additional Ramada; Schedule, if more space is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and
<br />representatives are named as additional insured as required by written
<br />contract per the attached blanket endorsements. This insurance is primary
<br />and non-contributory.
<br />r�7
<br />CERTIFICATE HOLDER CANCELLATION 1Io t'1 I 19 r raqe Iili,f-,3
<br />SANTAAN
<br />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 its Officers
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Employees, Agents, Volunteers
<br />and Representatives
<br />220 S Daisy Ave (M-85)
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92703
<br />ACORD 26 (2010/05)
<br />O 1988.2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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