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NICHCON-02 <br />/�� <br />CERTIFICATECERTIFICATEOF LIABILITYINSURANCE <br />MCGRAWN <br />OATE1 01VYYS'} <br />9f1112112tlfi9 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATEHOLDER, - - - <br />IMPORTANT: If the, certificate holder Is an ADDITIONAL INSURED, the po8cy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject.. to the terms and conditions of the policy, certain policies may require an endorsement A.statement on <br />this certificate does not confer rights to the Certificate holder In 8eu of such endorsement($ <br />PROOUCER%icehso# PES7799 .__. <br />IDA Insurance Services <br />4370 La Jolla Village Drive <br />Suite 000 <br />San Diego, CA$2122, <br />C c>'. Erica <br />Wlison <br />NooNr ,Exf: <br />858 764-006350233 Ar}c Nn (619 :674-6288 <br />E Er <br />—^— <br />ea.Wilson lmi ustrorm <br />iNaUrsERlstnvPo, RaiNo ppyt:Rgga. <br />Alr <br />IN LI ERn RLl lnsuraneeCompany <br />13068 <br />INSURED - <br />Nichols Consulting Engineers, CHTO. <br />1885$, Arlington. Ave.,#111 <br />Rego, NV 89509 <br />su RE R 8 1 Crum & F0I'SlES_paciaitkinsuranca ComPan <br />445 0 <br />uas MIND! <br />.,.-.. <br />INSUI £ <br />INSURER i <br />INSURER F r <br />CERTIFICATE NUMBER, F{i,((StoN rIumts <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI01) <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OT.HERDOCUMENTWITH RESPECTTOWHICH THIS. <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HFREINIS-SUSJECTTOALLT$ETERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN: REDUCED BY PAID CLAIMS:. <br />INSR <br />TYPa OP MBURANCa <br />AD LSUER <br />POLICY NUMBER . <br />:...POLICY EFF. <br />POLICY EX <br />LIMITS. <br />A <br />IXECOMMENCI.ALOUNE.ULCY <br />DN.MOE OCCUR <br />nk <br />PSBQ003222 <br />5117/2019ntLiab/$ev,F6 <br />I <br />/1712$2$ <br />AC U ENCE <br />0 <br />1x$0$I$0A <br />MED EXP (m RWe L1 cnl <br />.....�._.. <br />3:,,— <br />... <br />R. ADVtNJt�7 <br />1,00$,t160 <br />� <br />GENLAGGREG ELIMtTAPP SFER: <br />POLIGVx dLT LOG <br />. OTHER <br />2,0 0,$00 <br />- OMP P <br />2,$$$"00$ <br />DodUCtible <br />,0 <br />A <br />AUTOM081LELIABlUTY <br />OMOINEOSINGLE LIMIT <br />t,OQ$,$$0 <br />goiLYI RYPer asnn <br />If <br />X <br />ANYAUTO <br />SCHESot1LE0'. <br />AUTWONLYPx <br />'AM Aq, novels <br />wo <br />x <br />PSAi)601184 <br />�� <br />6/1712019 <br />'611712020 <br />Y INJURY'Peraculmni <br />§;_,,,,,_„`_ <br />a EdR at AGE <br />X <br />UMBRELLA UAB X OCCUR- <br />EXCESS UFa CLAIMS.MADE <br />PSE0003030 <br />8117/2019 <br />W1712020 <br />ACH OCOURRENf'E <br />1-6,000,000 <br />AGGRE©Are. <br />s _ 61000,000 <br />ET <br />DEO Fx RENTIONS 0 <br />A <br />WORKER5 COMPENSATION <br />NDEMP OC101MS'LIA LOA <br />ANYPRCPRIarORIPARTNERIEXECUTIVe YI <br />F{ ER)M %I <br />(ManS1a<on'EIn NHR EXOLttO542 N <br />lryEas damdantInd. <br />S RPTIONO OPERATI0N5 elow <br />naA <br />X <br />.. <br />PSW0001965 <br />y <br />15/17/2019 <br />) <br />511712020 <br />_,_, <br />OTH- <br />L. AG ZCNT <br />£ 1,066,00¢ <br />. <br />1,040,0 $ <br />_ <br />E.L ISEASE-POLICY �1 tT <br />11000,000. <br />B <br />Prof Liob/Cims Made. - <br />PKC108625 <br />517/2019 <br />4117/2020 <br />Per Claim <br />2,000,000 <br />8 <br />Dada$1OkPer Claim <br />PKC108825 <br />5/17/2019 <br />SM7/2020 <br />Aggregate <br />2,000,000 <br />OFOF OPERATIONS I LOCATIONS [VEHICLES (AOOM 101, AddaPonul Ramarke Sohedute,!nay tja attachod if Mom Spam is repuirad) <br />Re: AIi Operafions . <br />City of Santa Ana, its officers,: employees, agents and representatives are Additional Ipsuredswith respect to General and Auto Liability partite attached <br />endorsements as raouired by written contract. Insurance Is Primary and Non -Contributory. Waiver of Subrogation applies to Workers' Componsation. <br />30 bays Notice of Cancellation With 10 Days Notice for Non -Payment of Premium ill accordance with the policy provisions.: <br />REVIEWED & APPROVED <br />C RTIP CATS HOLDER... v,BY RiskMANAGEMENT iVISION CANCELLAPPN <br />_ <br />SHOULD ABOVE DESCRIBEDPOLICIESCANCELLED BEFORE <br />THEIN <br />TE THEREONOTICEIWLBE DELIVERED <br />EXPRDATE <br />ACCORDANCE WITH THE POLICY PROVIStCN9, <br />City Of Banta Ana SAMA e HA M, LAMBER <br />Risk Management Division <br />20 Civic Cantor Plaza <br />AUTHORIZED REPRESENTATIVE <br />.._.1SantaAna-0A927n2 — <br />—. <br />ACORD.26 (2016103) Ud 1908-2016 ACORD CORPORATION. All rights reserved, <br />The ACORD name and logo. are registered marks of ACORD <br />