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A`oRhP CERTIFICATE OF LIABILITY INSURANCE <br />oATE(M o2D ) <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 INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />ER <br />Cavigcnac &Associates <br />450 B Street, Suite 1800 <br />San Diego CA 92101 <br />AC <br />IeEE.. T Certificate Department <br />PHONE rI, 619-744-0574 iglu' No :619-234-8601 <br />E4AIL mrtifiUtes@Cavignac.com <br />INSURER(S) AFFORDING COVERAGE <br />NAICN <br />INSURER A: Valley Forge Insurance Company <br />20508 <br />INSURED NV5INCO-01 <br />NV5, Inc. <br />163 Technology Drive Suite 100 <br />INSURER B: Continental Casualty Co. <br />20443 <br />INSURERC: Continental Insurance Company <br />35289 <br />Irvine, CA 92618 <br />INsuRER o: Trans ortation Insurance Co. <br />20494 <br />INSURER E: Berkl Insurance Company <br />32603 <br />INSURER F: <br />NLIMRFR• <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 N{R <br />TYPE OF INSURANCE <br />DDL <br />UBR <br />POLICY NUMBER <br />POLICY EFF <br />MMID rYY1' <br />POLICY E)IP <br />flmmmoYYnlLIMnS <br />A <br />COMMERCIAL GENERAL LIABILITY <br />CIAIMS-MADE �OCC <br />Tx_:W <br />Y <br />60570a05M <br />5112020 <br />✓ <br />VW021 <br />/ <br />EACH OCCURRENCE <br />51,000.000 <br />PREM EaEME nc <br />S1000.W0 <br />MED EXP(M me proem) <br />. LMhrswri <br />✓ <br />$15.000 <br />Ne <br />PERSONAL A AOV INJURY <br />$1000,000 <br />GEM AGGREGATE LIMIT APPLIES PER <br />X POLICY Z�a �LOC <br />GENERAL AGGREGATE <br />S 2 %Ie= <br />PRODUCTS-COMPIOPAGG <br />S2,M.D00 <br />SW GM Liabft <br />s1Ob0.00D <br />OTHER <br />B <br />AUTOMOB <br />LIABILITY <br />ANY AUTO <br />Y <br />6057G40575 <br />51120200 <br />/ <br />511=1 <br />Ix, <br />COMeBINEEnD SINGLE LIMIT <br />S <br />X <br />EDGILY AY IN, person) <br />S <br />ALL OWNED SCHEDULED <br />Autos AUTOS <br />✓✓✓ <br />BODILY INJURY(Per attlderd) <br />$ <br />MIRED Alr05 AUTOS ED <br />AUTOS <br />PROPERTY DAMAGE <br />4 <br />S <br />C <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />CUEW76054554 <br />yt2020 <br />5112a21 <br />EACH OCCURRENCE <br />$2CoXr 0 <br />AGGREGATE <br />S20,Xo= <br />EXCESS LIAB <br />CWMS-MAOE <br />DEO I X <br />I RETENTION <br />S <br />D <br />WORKERS COMPENSATION <br />AND EMPLOYERTLIABILITY YIN <br />ANY PROPRIETORIPARTNER/EXECUTIVE <br />OFFICERAIEMBER EXCLUDED? <br />NIA <br />YtC657040558 <br />5,12020 <br />5112021 <br />X PFR OTH- <br />T F. <br />EL EACH ACCIDENT <br />51,OOp,Opp <br />E.L. DISEASE - EA EMPLOYEE <br />S1.000.000 <br />(Manda"M NH) <br />e yyeass des Jss under <br />DESCRIPTION OF OPERATIONS below <br />EL DISEASE -POLICY LIMIT <br />S1.,XOW0 <br />E <br />PmleaumalIPWOhm Liability <br />AEC903636500 <br />51112020 <br />511=21 <br />Earn Claim S1000D000 <br />Agglega(e 52D000.0gD <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101. AddlOmel Remarks Schedule. may be MMched N moo apace N reeulred) <br />Re: On -Call Water Resources. Additional Insured coverage applies to General Liability and Automobile Liability for City of Santa Ana, its officers, employees, <br />agents and representatives per policy form. Excess/Umbrella policy follows form over underlying policies: General Liability, Auto Liability 8 Employers Liability <br />(additional insured and waiver of subrogation apply). Professional Liability - Claims made form, defense Costs included within limit. Primary coverage applies to <br />General Liability and Automobile Liability per policy form. If the insurance company elects o cancel or non -renew Coverage a 30 days written notice of such <br />cancellation or nonrenewal will be provided and 10 days for nonpayment of premium. J <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92702 <br />APR/ / I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />(C7yJ`0/lFyAt/j/nY(no THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ANCfIE ACEVEdo <br />All rinHle .n.a—A <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />