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FEHR&PE-01
<br />THOMASR
<br />A� o CERTIFICATE OF LIABILITY INSURANCE
<br />OATDDIYYYY)
<br />a1281zalzozo
<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 ondorsemen s .
<br />PRODUCER License # OE67768
<br />IDA Insurance Services
<br />3875 Hopyard Road
<br />Suite 200
<br />Pleasanton, CA 94588
<br />CONTACT Gigi Yuen
<br />PHONE AIX
<br />(ABC, No, Eat): (925) 660-3514 50008 (A, No :(925) 416-7869
<br />E-MAIL . Gigi.Yuen@ioausa.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC M
<br />INSURER A: RLI Insurance Company
<br />13056
<br />INSURED
<br />INSURER B:TrumbullInsurance Company
<br />27120
<br />INSURER C: Liberty Insurance Underwriters Inc
<br />19917
<br />Fehr & Peers
<br />100 Pringle Avenue, Suite 600
<br />Walnut Creek, CA 94596
<br />INSURER D :
<br />INSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER' REVISI N N
<br />O UMBER.
<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 CONTRACTOROTHER DOCUMENTWITH RESPECTTOWHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THETERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />TYPE OF INSURANCE
<br />ADDL
<br />D
<br />SUER
<br />WVn
<br />POLICY NUMBER
<br />POLICY EFF
<br />IMMIDEACH
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS-MADELAJ OCCUR
<br />PS80006683
<br />121612019
<br />1216/2020
<br />DAMAG'ETOR NTUD
<br />PREMISMED
<br />1,000,000
<br />$
<br />I1
<br />EXP (Any one erson
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />AGGREGATE LIMIT APPLIES PER
<br />PE�
<br />GENERALAGGREGATE
<br />$ 4,000,000
<br />GEN'L
<br />PRODUCTS-COMPIOP AGG
<br />$ 4,000,000
<br />POLICY LOC
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMaBINEEDISINGLE LIMITfLa
<br />1,000,000
<br />$
<br />BODILY INJURY Per erson
<br />$
<br />ANY AUTO
<br />PSA0002276
<br />12/612019
<br />121612020
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />1
<br />BODILY INJURY Per accident)
<br />X
<br />XSONAUOS ONLY NON-OWNo
<br />PRR
<br />OPERTYDAMAGE
<br />A
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />5+000+000
<br />X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />PSE0002889
<br />121612019
<br />121612020
<br />AGGREGATE
<br />5,000,000
<br />DED RETENTIONS
<br />B
<br />X PER ERµ
<br />AND EMPLOYERS'LIABILIITY YIN
<br />EL. EACH ACCIDENT
<br />$ 1,000,000
<br />ANY PROPRIETORIPARTNER/EXECUTIVE
<br />NIA
<br />57WEGZJ7989
<br />51112020
<br />5/1/2021
<br />O0ppFICERIMEMBER EXCLUDED?
<br />NH)
<br />lfym
<br />E.L. DISEASE -EA EMPLOYE
<br />$ 1,000,000
<br />describe
<br />EL DISEASE-POUCVLIMB
<br />$ 1,000,000
<br />DESCRIPTION PTION OF OPERATIONS can.
<br />C
<br />Professional Liab.
<br />AEXNYABEFJ2004
<br />12/612019
<br />121612020
<br />Per Claim
<br />5,000,000
<br />C
<br />Professional Liab.
<br />AEXNYABEFJ2004
<br />121612019
<br />121612020
<br />Aggregate
<br />5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES ACORD 101, Additional Remarks Schedule. maybe attached if more space is required)
<br />RE: P19-1593 Santa Ana On -Call VMT - OC20-0410.00, OC20-07%01 & OC19-STAN.00
<br />All Operations of the Named Insured, including the aforementioned project, if any.
<br />General Liability: Please see blanket Additional Insured endorsement attached; such coverage is Primary and Non -Contributory, as required per written
<br />contract.
<br />Auto Liability: No company owned vehicles. Please see blanket Additional Insured endorsement, as required per written contract.
<br />GENERAL LIABILITY & AUTO LIABILITY INCLUDE THE FOLLOWING PERSON(S) OR ORGANIZATION(S): The City of Santa Ana, its officers, employees,
<br />agents and representatives, as required per written contract
<br />30-Day Notice of Cancellation is included per policy provisions. I]
<br />By RISK ly"1111-.. -
<br />2
<br />City of Santa Ana
<br />Risk Management Divis4,11dFloor
<br />20 Civic Center Plaza
<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 />AUTHORIZED REPRESENTATIVE
<br />^��•-� —� t—� • �•�-I ll TBDO-ZU10 AGUKU GUKPUHA I ION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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