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Client#: 25320 <br />'R.-eNGv CCk IN <br />J ce4tur Mende- <br />KIMLHORN <br />A-2bIb-b'L;�- <br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE <br />DATE 312512IDDIYYYY) <br />/2512018 <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 any rights t0 the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Greyling Ins. Brokerage/EPIC <br />3780 Mansell Road, Suite 370 / <br />CONTACT <br />NAME: Jerry Noyola <br />PHONE 770552d225 S66b50+L082 <br />AIC Eat: AK: No: <br />R. <br />ADDRESS, jerry.noyofa@gFreyling.com <br />Alpharetta, GA 30022 <br />INSURER(9) AFFORDING COVERAGE <br />NAIC0 <br />INSURER �N•dene Union Fee me. co. <br />19445 <br />INSURED <br />INSURERS: Aspen Ametleen lneannea gempeny <br />43460 <br />Kimley-Horn and Associates, Inc. <br />421 Fayetteville Street, Suite 600 <br />Raleigh, NC 27601 / <br />INSURER C: New Hamp•hhe In& co. <br />23841 <br />IxsuREg D: uoya•ononaon <br />085202 <br />INSURER <br />INSURER F: � <br />COVERAGES CERTIFICATE NUMBER: 18.19 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 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 />LTR <br />TYPE OF INSURANCE <br />INSR <br />SYND <br />POLICYNUMSER <br />PMIDINYYYFY <br />MWDUY� <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />5268169 <br />4/01/2018 <br />04/01/2019 <br />EACHOCCURRENCE$1000000 <br />CLAIMSMADE OCCUR <br />PREMISES Ee ovcurrence <br />$500,000 _ <br />MED EXP(Any one person) <br />TXCI ntractual Liab. <br />$25,000 <br />PERSONAL S ADV INJURY <br />$1 000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY JEOOT [�J LOC <br />GENERAL AGGREGATE <br />$2,000,000 <br />GEN'L <br />PRODUCTS -COMPIOP AGG <br />$2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />4489663 <br />4/0112018 <br />0410112019 <br />EeMBBINEDISINGLE LIMIT <br />1,000,000 <br />BODILY INJURY(Perp...) <br />$ <br />X <br />ANY AUTO <br />X <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NO WINED <br />AUTOS ONLY X AUTOS ONLY <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTVDAMAGE <br />Peracdtlent <br />$ <br />$ <br />B <br />)( <br />UMSRELLALMe <br />X <br />OCCUR <br />CX005FT18 <br />410112018 <br />04/01/201 <br />EACH OCCURRENCE <br />$5 000 000 <br />AGGREGATE <br />$5 000 000 <br />EXCESS LAS <br />CLAIMS -MADE <br />OEO I X RETENTION$0 <br />$ <br />C <br />A <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YtN <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? N <br />(Maddetory In NH) <br />NIA <br />015893685 (ADS) <br />015893686(CA) <br />039326820 (ME) <br />1410112018 <br />410112018 <br />410112018 <br />04/0112019 <br />0410112019 <br />04101/201 <br />X PER OTH- <br />E.L. EACH ACCIDENT <br />$1000000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />D <br />Professional Liab <br />P070831800 <br />4I0112018 <br />0410112019 <br />Per Claim $2,000,000 <br />Aggregate $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />Re: Warner Avenue Improvements, Phase 2 City, its officers, employees, agents, volunteers and <br />representatives are named as Additional Insureds with respects to General Liability where required by <br />written contract. The above referenced liability policies with the exception of workers compensation and <br />professional liability are primary & non-contributory where required by written contract. Separation of <br />Insureds applies to the General Liability Policy. Should any of the above described policies be cancelled by <br />(See Attached Descripti <br />City of Santa Ana <br />Box 1988 <br />Santa Ana, CA 92702-1988 <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 />ACORD 25 (2016/03) 1 Of 2 <br />#S10195451M1017400 <br />law- <br />O 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />JNOY1 <br />