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PAULUS ENG JLOP
<br />ACOROp CERTIFICATE OF LIABILITY INSURANCE DATE915/2 D/VYYY)
<br />�s�2o19
<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 endorsements .
<br />PRODUCER CONTACT
<br />.NAMI": —
<br />THE BROKERAGE COMMERCIAL INSURANCE SERVICES, Inc. PHONE FAX
<br />20261 SW Acacia St., Suite 200(A/C, No,.Ext : 949 287-5677 LAIC, No):
<br />Newport Beach, CA 92660
<br />lN. URFRLSI9FF G VERAGENAIC #
<br />r,.:Executive Risk Indmn2a, Inc. 135181 _
<br />INSURED ,rJRIIRFR R Federal Insurance Comoanv 120281
<br />Paulus Engineering, Inc.
<br />2871 E. Coronado Street
<br />Anaheim, CA 92806
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REVISION_ NUMBER: 1
<br />THIS
<br />IS TO CERTIFY THAT THE POLICIES OF
<br />INSURANCE
<br />LISTED BELOW HAVE BEEN ISSUED TO THE INSURED
<br />NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED.
<br />NOTWITHSTANDING ANY REQUIREMENT,
<br />TERM OR CONDITION OF ANY CONTRACT OR OTHER
<br />DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE
<br />MAY BE ISSUED OR MAY PERTAIN,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS
<br />AND CONDITIONS OF SUCH POLICIES.
<br />TYPE OF INSURANCE ,AD DL
<br />SUBR
<br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />POLICY NUMBER ( POLICY EFF POLICY EXp
<br />MM/DD/YYYYI(.(
<br />LIMITS
<br />INSR
<br />LTR
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />1,000,000
<br />CLAIMS -MADE occuR
<br />X
<br />54303105 5/1/2019 511/2020
<br />DAMAGE Laaw4Tuue
<br />100,000
<br />ME
<br />5,000
<br />ONAL&ADV INJIU Y
<br />S 1,000,000
<br />GERLAGGRE4�!�
<br />�T� LIMIT APPLIES PER:
<br />POLICY I x I PRO- LOC
<br />GE RAI AGGREGATE
<br />PRODUCTS -COMP/OP AQG_
<br />2,000,000
<br />_ 2'000'000
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINMELIMIT
<br />$ 1,000,000
<br />BODILY INJURY (Perpersonl. person
<br />S
<br />X ANY AUTO
<br />54303104 5/1/2019 5/1 /2020
<br />BOOII�Y IN.IUR er accident
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />OPEIifY AMRGE
<br />°f e�alde
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />S
<br />UMBRELLA LIAB OCCUR
<br />HCLAIMS-MADE
<br />EACH OCCURRENCE
<br />AG RE ATE
<br />EXCESS LIAR
<br />DED RETENTION $
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />Y. N.
<br />OFFICERIMEMBER EXCLUDEDANY PROPRIETOR/PARTNERIEX? ECUTIVE
<br />(Mandatory In NH)
<br />NIA
<br />54303106
<br />5/1/2019
<br />5/1/2020
<br />X I PER UTF OTH-
<br />STAT ..ER.
<br />.EACH ACCIDENT
<br />. DISEASE - EA EMPLOYE
<br />1,000,000
<br />1,000,000
<br />F I➢1SEA - - POLICY LIMIT
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />1,000,000
<br />I
<br />DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attachod if more space is required)
<br />RE: Santa Ana Emergency Work. glaip
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Named as Additional Insureds as respects General Liability per
<br />Attached Endorsement.
<br />This Insurance shall apply as Primary and Non -Contributory per attached endorsement.
<br />REVIEWED & APPROVED
<br />rAMr=1 I AT1ntJ
<br />1 2�LAREAL
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Divisl
<br />20 Civic Center Plaza RANCINE R. VIL
<br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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