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ACOR" CERTIFICATE OF LIABILITY INSURANCE 5/1/2023 <br />DDYYY) <br />FD;AE(MMIY <br />22/2022 <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 endorsement(s). <br />PRODUCER Lockton Companies <br />CONTACT <br />NAME: <br />444 W 47th Street, Suite 900 <br />City MO 64112-1906 <br />(816)960-9000 <br />PHONE FAX <br />o Ext : AIC No <br />fAIC.Kansas <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Berkshire Hathaway Specialty Insurance Company- <br />22276 <br />INSURED STANTEC CONSULTING SERVICES INC. <br />1415077 370 INTERLOCKEN BOULEVARD, SUITE 300 <br />INSURER B: Travelers Property Casualty Co of America <br />25674 <br />INSURER C : <br />INSURER D : <br />BROOMFIELD CO 80021-8012 <br />INSURERE: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 17616444 REVISION NUMBER: XXXXXXX <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 CONTRACT OR 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MM DDIYYYY <br />POLICY EXP <br />MM DDIYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 1 OCCUR <br />Y <br />Y <br />47 - GLO-307584 <br />5/1/2022 <br />5/1/2023 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />DAMAGE Sf RENTED <br />PREMISES Ea occurrence <br />$ 1,000,000 <br />X <br />MED EXP (Any one person) <br />$ 25,000 <br />CONTRACTUAL/CROSS <br />X <br />XCU COVERED <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 41000,000 <br />POLICYFRIJECT PRO- � LOC <br />PRODUCTS - COMP/OP AGG <br />$ 2 000 000 <br />$ <br />OTHER: <br />B <br />B <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />N <br />N <br />2 _ <br />TJ-B CAP-086 8 0 (AOS) <br />TJ-BAP-8E086820 <br />5/1/2022 <br />5/1 /2022 <br />5/1/2023 <br />5/1 /2023 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ XXXXXXX <br />BODILY INJURY (Per accident) <br />$ XXXXXXX <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />PROPERTY DAMAGE <br />Per accident <br />$ XXXrXXrXrX <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />$XXXXXXX <br />A <br />Xr <br />UMBRELLA LIAB <br />FOLAIMS-MADE <br />CCUR <br />N <br />N <br />47 - UMO-307585 <br />5/1/2022 <br />5/1/2023 <br />EACH OCCURRENCE <br />$ 5 00O 000 <br />AGGREGATE <br />$ 5,000,000 <br />EXCESS LIAB <br />DED I I RETENTION $ <br />$ XXXXXXX <br />B <br />B <br />B <br />WORKERSCOMPENSATIONEMPLOYERS' <br />ILIT <br />AND EMPLOYERS' LIABILITY <br />LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N <br />OFFICER/MEMBER EXCLUDED? � <br />(Mandatory in NH) <br />NIA <br />Y <br />UB-3P635310 (AOS <br />UB-3P533004 (MA, WI) <br />EXCEPT FOR OH ND WA WY <br />5/1/2022 <br />5/1/2022 <br />5/1/2023 <br />5/1/2023 <br />X STATUTE EERH <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />STANTEC PROJECT #2042; RFP NO. 20-102 AGREEMENT A-2020-205-03; ON -CALL STORMWATER PROJECT DESIGN SERVICES. THE CITY OF SANTA ANA, <br />ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTITIVES ARE ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY, IF <br />REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION APPLIES TO GENERAL LIABILITY AND WORKERS COMPENSATION/EMPLOYER'S <br />LIABILITY WHERE ALLOWED BY STATE LAW AND IF REQUIRED BY WRITTEN CONTRACT. <br />CERTIFICATE HOLDER CANCELLATION See Attachments <br />17616444 <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92701 <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 REPRESENTATIV ...... t:'�4vis��p <br />' & APPROVED r58r <br />^" � YC� I¢trtc c'a^rr,J�aS <br />(719A8+, 015 ACORD C( RizkManagerrxnxCledcalAde <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />