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r1dllUlitl n. VUlaleal vnmraai <br />Da ts: 2021.06.1415:53:49-0]'00' <br />ACo'Ro� CERTIFICATE OF LIABILITY INSURANCE <br />�.. 5/1/2022 <br />DATE (Ni <br />5/21/2021 <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(les) 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 />444 W. 47th Street, Suite 900 <br />Kansas City MO 64112-1906 <br />(816)960-9000 <br />CONTACT <br />PHONE FAX <br />Ezt : pIC No <br />E-MAUL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC q <br />INSURER A: Berkshire Hathaway Specialty Insurance Company <br />22276 <br />INSURED STANTEC CONSULTING SERVICES INC. <br />INSURER B: Travelers Property Casualty Co of America <br />25674 <br />INSURER C : <br />1415077 370 INTERLOCKEN BOULEVARD, SUITE 300 <br />BROOMFIELD CO 80021-8012 <br />INSURER D <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 175R46RI REVISION NIIMRFI vvvv vvsr <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 />INSD <br />SUER <br />MO <br />POLICY NUMBER <br />POLICY EFF <br />IMMI <br />POLICY EXP <br />MM/DDIYVYV <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />LlCLAIMS -MADE X OCCUR <br />Y <br />Y <br />47-GLO-307584 <br />5/1/2021 <br />5/1/2022 <br />EACHOCCURTNTE <br />$ 2,000,000 <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 />PERSONq <br />RY <br />s 2000000 <br />GEN'L <br />AGGREGATE LIMITAPPLIES PER: <br />POLICY � JEo FX LOG <br />$ 4000000 <br />AGG <br />$ 2 000 000 <br />EGENERALE <br />$ <br />OTHER: <br />B <br />B�.ANY <br />AUTOMOBILE <br />LIABILITY <br />AUTO <br />N <br />N <br />TC2J-CAP-8EO86819(ADS) <br />TJ-BAP-8E086820 <br />TC2J-CAP-8EO87017(NJ) <br />5/l/2021 <br />5/1/2021 <br />5/1/2021 <br />5/1/2022 <br />5/1/2022 <br />5/1/2022 <br />Ea IT <br />$ 1000Q00B <br />rson) <br />$ XXXXXXX <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED AUTOSONLY AUTOS ONLY WNED <br />RODILY Icclden) <br />$ XXXXXXX <br />PROPERTY <br />ac RdTV DAMAGE <br />$ XXXXXXX <br />$XXXXXXX <br />A <br />X <br />UMBRELLA LIAB <br />]( <br />OCCUR <br />N <br />N <br />47-UMO-307585 <br />5/1/2021 <br />5/1/2022 <br />EACH OCCURRENCE <br />$ 5000000 <br />X <br />AGGREGATE <br />$ 5,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DEC I I RETENTION$ <br />$ XXXXXXX <br />B <br />B <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY <br />ANY PROPRIETORIPARTNIIXECUTIVE V/N <br />OFFICER/MEMBER EXCLUDED? <br />(Myandatory In NH) <br />describe under <br />DESCRIPTION OF OPERATIONS below <br />N /A <br />N <br />UH-3P635310((AOS) <br />UB-3P533004 (MA, WI) <br />EXCEPT FOR OR ND SAIA WY <br />5/1/2021 <br />5/1/2021 <br />5/1/2022 <br />5/1/2022 <br />PER OTH- <br />X STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1000 OQO <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1 000000 <br />E.L. DISEASE - POLICY LIMIT <br />1 $ 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addillonal Remarks Schedule, maybe attached If more space Is roquired) <br />STANTEC PROJECT N2042 REP 17-083, AGREEMENTA-2018-159-09, ON CALL ENGINEERING SERVICES. CITY, ITS OFFICERS, EMPLOYEES, <br />AGENTS, VOLUNTEERS AND REPRESENTATIVES ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY AND PHIS COVERAGE IS <br />PRIMARY AND NON-CONTRIBUTORY, IF REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION APPLIES TO GENERAL LIABILITY <br />WHERE ALLOWED BY STATE LAW AND IF REQUIRED BY WRITTEN CONTRACT. <br />17584683 <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />RISK MANAGEMENT DIVISION THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS. <br />.SANTA ANA CA 92701 AUTHORIZED REPRESENTATIV ,�1 <br />Milon <br />7 i'4 �i % REVIEWED M& N Dm BY.' <br />© 1988 015 ACORD CI 1 e V <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 1/„ <br />RISN MdnagemeMADalysk <br />