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<br />A� o CERTIFICATE OF LIABILITY INSURANCE
<br />DAT DM DDNYYY)
<br />0312812010
<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(les) must have ADDITIONAL INSURED provisions or be endorsed, If
<br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this
<br />certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
<br />PRODUCER
<br />Aon Risk services central, Inc.
<br />Pittsburgh PA Office
<br />CONTACT
<br />NAME'
<br />lac No. Eat): (866) 283-7122 Na : (800) 363-0105
<br />Dominion Tower, 10th Floor
<br />625 Liberty Avenue
<br />E-MAIL
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE NAICe
<br />Pittsburgh PA 15222-3110 USA
<br />INSURED
<br />INSURERA: XL Insurance America Inc 24554
<br />Michael Baker International, Inc
<br />5 Hutton Centre Drive
<br />Suite 500
<br />INSURER B: Liberty Mutual Fire Ins Co 23035
<br />INSURER C: Liberty Insurance Corporation 42404
<br />Santa Ana CA 92707 USA
<br />INSURER D: Lloyd's syndicate NO. 2623 AA1128623
<br />INSURER E:
<br />General Liability
<br />INSURER F'
<br />COVERAGES CERTIFICATE NUMBER: 570070606569 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. Limits shown are as requested
<br />INSR TH
<br />TYPE OF INSURANCE
<br />150
<br />MD
<br />POLICYNUMBER
<br />MMR)0
<br />MMIOOrrYYY
<br />LIMITS
<br />% COMMERCIAL GENERAL LIABILITY
<br />20 C1VAn center Plaza (M-20)
<br />Santa Ana CA 92702 USA
<br />_
<br />TB
<br />EACH OCCURRENCE $2,000,000
<br />CLAIM&MADE ❑X OCCUR
<br />General Liability
<br />urm $300,000
<br />PREMISES (I amnm
<br />MED EXP (Any ane person) $10,000
<br />PERSONAL& ADV INJURY $2,000,000
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />GENERALAGGREGATE $4,000,000
<br />POLICY ❑X PECO- AI LOC
<br />PRODUCTS-COMP/OPAGG $4,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILELIABILIY
<br />AS2-681-004145-727
<br />commercial Auto - ADS
<br />0830201708/30/2018
<br />COMBINED SINGLE LIMIT
<br />ISaacamemo $2,000,000
<br />BODILY INJURY ( Par person)
<br />X ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLYAUTOS
<br />HIRED AUTOS NON -OWNED
<br />ONLY AUTOS ONLY
<br />BODILY INJURY (Per accident)
<br />PROPERTY DAMAGE
<br />Per acoldent
<br />A
<br />X
<br />UMBRELLA LIAB X OCCUR
<br />U5000799$2LI17A
<br />118/30/Z018
<br />EACH OCCURRENCE $10,000,000
<br />EXCESS LIAR CLAIMSMADE
<br />umbrella
<br />AGGREGATE $10,000,000
<br />DEO X ftETENTIONS10,000
<br />C
<br />SCOMAENSA ON AND
<br />WORKERS
<br />YIN
<br />ANY PROPRIETOR/ PARTNE8I EXECUTIVE
<br />wA768DO04145777
<br />workers COMP - ADS
<br />E08/31/'2017
<br />-68/30/2019
<br />ETH -
<br />X STATUTE 0
<br />E.L.EACHACCIDENT $1,000,000
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />NIA
<br />EL. DISEASE -EA EMPLOYEE $1,000,000
<br />If yyea, tlesrnbe under
<br />DE SCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />D
<br />E8A-PL-Primary
<br />PSDEF1700460
<br />08/31/2018
<br />Per Claim $$,000,000
<br />Professional Liab. and CP
<br />Aggregate $5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached 8 more space is required)
<br />For Named Insured Only: Attn: Kim Hartsfield. RE: Project Name: CEQA/NEPA On-call Environmental services. City of Santa
<br />Ana, its officers, agents, employees volunteers and representatives are included as Additional Insured in accordance with the
<br />policy provisions Of the General Lia(lilit policy. General Liability policy evidenced herein is Primary and Non-contri 6utory
<br />to other insurance available to Additional Insured, but only in accordance with the policy's provisions, should General
<br />Liability, Automobile Liability, Professional Liability and workers' compensation policies be cancelled before the expiration
<br />date thereof, the policy provisions will govern how notice of cancellation may be delivered to Certificate Holders in
<br />accordance with the policy provisions,
<br />CERTIFICATE HOLDER
<br />CANCELLATION U
<br />01988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE
<br />DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />City of Santa Ana
<br />AUTHORIZED REPRESENTATIVE
<br />Attn: Executive Director
<br />20 C1VAn center Plaza (M-20)
<br />Santa Ana CA 92702 USA
<br />_
<br />01988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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