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Last modified
7/27/2021 11:09:39 AM
Creation date
7/27/2021 11:08:26 AM
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Contracts
Company Name
STANTEC
Contract #
A-2018-172-01
Agency
Public Works
Council Approval Date
7/3/2018
Expiration Date
7/2/2022
Insurance Exp Date
10/1/1900
Destruction Year
2027
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Digitally signed by Frandne R. <br />Francine R. Villareal Villareal <br />AC®RO® CERTIFICATE OF LIABILITY INSURANCE G <br />�..� 5/1/2022 <br />DATE(MM/DDYYYY) <br />4/22/2021 <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(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 />444 W. 47th Street, Suite 900 <br />Kansas City MO 64112-1906 <br />(816)960-9000 <br />CONTACT <br />PHONE FA% <br />Ext • ac No <br />MAIL <br />ADDRESS: <br />INSUREI AFFORDING COVERAGE <br />NAIC q <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 ofAmerica <br />25674 <br />INSURER C <br />BROOMFIELD CO 80021-8012 <br />INSURER D <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 15553615 REVISION NUMBER: YYYYYYY <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 />ADDLSUBR <br />INSD <br />=0 <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MM/DDfYYYV <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />Y <br />N <br />47-GLO-307584 <br />5/1/2021 <br />5/1/2022 <br />EACH OCCURRENCE <br />$ 2 00O OOO <br />DA E END <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 S ADV INJURY <br />$ 2,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY [X] jEC'T ly LOG <br />GENERAL AGGREGATE <br />$ 4000000 <br />GEN'L <br />PRODUCTS - COMPIOPAGO <br />$ 2,000,000 <br />$ <br />OTHER: <br />B <br />B <br />B <br />AUTOMOBILE <br />X <br />UABILITY <br />ANY AUTO <br />N <br />N <br />TC2YCAP-8E086819 (AOS) <br />TJ-BAP-8E086820 <br />TC2J-CAP-8EO87017(NJ) <br />5/1/2021 <br />5/t/2021 <br />5/1/2021 <br />5/l/2022 <br />5/1/2022 <br />5/1/2022 <br />COMBINEOSINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY(Perperson) <br />$ XXXXXXX <br />OWNEAUTOSUONLY ALITOSULED <br />AUTOS ONLY ED AUTOS ONLY WNED <br />BODILY INJURY (Per accident) <br />$ XXXXXXX <br />PROPERTY <br />rrec IcdentDAMAGE <br />$ XXXXXXX <br />sXXXXXXX <br />A <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />N <br />N <br />47-UMO-307585 <br />5/l/2021 <br />5/1/2022 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />AGGREGATE <br />$ 5,000,000 <br />X <br />EXCESS LIAB <br />CLAIMS -MADE <br />BED I I RETENTION$ <br />I <br />lsxxxxxxx <br />B <br />B <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE YIN <br />RIM <br />OFFICEEMBER EXCLUDED? F <br />NIA <br />Y <br />UB-3PG35310 ((AOS) <br />UB-3P533004 (MA, WI) <br />EXCEPT FOR OH NO WA WY <br />5/1/2021 <br />5/1/2021 <br />$/1/2022 <br />5/l/2022 <br />PER OTH- <br />'X STATUTE ER <br />E.L, EACH ACCIDENT <br />$]000000 <br />E.L. DISEASE -FA EMPLOYEE <br />$ 1,000,000 <br />(Mandatory In NH) <br />If yes, al.ouibe under <br />E.L, DISEASE -POLICY LIMIT <br />$ 1000000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />RE: STANTEC PROJECT 9224801401; CLIENT PROJECT A-2018-172,A-2019-015 and A-2020-075-04 COST OF SERVICE STUDY FOR WATER AND SEWER <br />ENTERPRISES. CITY OF SANTA ANA AND ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ARE ADDITIONAL. <br />INSUREDS AS RESPECTS GENERAL LIABILITY AND THESE COVERAGES ARE PRIMARY, IF REQUIRED BY WRITTEN CONTRACT. WAIVER OF <br />SUBROGATION APPLIES TO WORKERS COMPENSATION/EMPLOYER'S LIABILITY WHERE ALLOWED BY STATE LAW AND IF REQUIRED BY <br />WRITTEN CONTRACT <br />15553615 <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVSION <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92702 <br />ACORD 25 (2016/03) <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 />4 �J RlekMnlag�ineat DNleipn <br />/'( 1 aA�REVIEWED&APPROVED BY: <br />©19S8 015 ACORD C £Mrnc>vF¢a <br />The ACORD name and logo are registered marks of ACORD--.��.1 Risk. Management Analyst <br />
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