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DI,
<br />Francine R. VillarealklVillafedi signed by Francine R.
<br />A`CORU� CERTIFICATE OF LIABILITY INSURANCE o9joi�2oZiYY)
<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 LID kOC36861 1-415-403-1491
<br />Alliant Insurance Services, Inc.
<br />CONTACTNAME: Kimberly Leikam
<br />PHONE 415-4U3-1491 F� No: 415-874-4818
<br />100 Pine Street, 11thFloor
<br />EMAIL kIs kamWalliant.com
<br />INSURERS AFFORDING COVERAGE
<br />NAICII
<br />INSURERA: VALLEY FORGE INS CO
<br />20508
<br />San Francisco, CA 94111
<br />INSURED
<br />INSURER B: TRANSPORTATION INS CO
<br />20994
<br />Layne Christensen Company
<br />INSURER C: STEADFAST INS CO
<br />26387
<br />INSURER D:
<br />585 Nest Beach Street
<br />INSURERE:
<br />INSURER Ft
<br />Watsonville, CA 95076
<br />COVERAGES CERTIFICATE NUMBER: 63094029 REVISION NUMBER:
<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 />ILTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />IMMIDDIYYYYI
<br />POLICY EXP
<br />(MMiDDIYYWILIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />X
<br />X
<br />GL2074978689
<br />10/01/20
<br />10/01/23
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE J OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES(Ea entrance
<br />$ 2,000,000
<br />X
<br />MED EXP(Any one arson)
<br />$ Nil
<br />XCU -
<br />Contractual Liability
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />X
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 10,000,000
<br />GENT
<br />POLICY [X] JEO LOC
<br />PRODUCTS. COMP/OP AGO
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />X
<br />BUA2074978692
<br />10/01/20
<br />10/01/23
<br />COMBINED SINGLE LIMIT
<br />E accident
<br />$
<br />2,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />%
<br />ANY AUTO
<br />%
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED NON -OWNED
<br />AUTOS ONLY X AUTOS ONLY
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per aocmenq
<br />$
<br />UMBRELLALIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LU\B
<br />CLAIMS -MADE
<br />DED RETENTION
<br />$
<br />A
<br />A
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANYPROPRIETORIPARTNEWEXECUTIVE
<br />BEREXCLUOED7 OFFICERIMEM
<br />(Mandatory In NH)
<br />NIA
<br />X
<br />X
<br />X
<br />WC274978630 (CA)
<br />WC274978644 (AOS/StopGap
<br />WC274978658 (NY)
<br />10/01/20
<br />10/01/20
<br />10/01/20
<br />10/01/21
<br />10/01/21
<br />10 /O1/21
<br />X 11SEATUTE ERH
<br />E.L. EACHACCIDENT
<br />$ 2,000,000
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 2,000,000
<br />B
<br />D SCRIPTIONes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />X
<br />WC274978661 (MT,WI,HI)
<br />10/01/20
<br />10/01/21
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 2, 000, 000
<br />C
<br />Professional Liability
<br />H00508792216
<br />10/01/20
<br />10/01/21
<br />Ha Claim/Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required)
<br />Re: On -Call Water Well, Pump, and Motor Rehabilitation and Repair Services
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional
<br />Insured as required by written and executed agreement per the attached endorsements. Coverage is primary &
<br />non-contributory and waivers of subrogation apply.
<br />30 Days Written Notice of Cancellation for Non -Renewal and 10 Days Notice of Cancellation for Non -Payment of Premiums
<br />GL Per ISO Form CG0001 10/01, AL Per ISO Form CA0001 10/13
<br />City of Santa Ana
<br />20 Civic Center Plaza (M-30)
<br />P.O. Box 1988
<br />Santa Ana, CA 92702-1988
<br />USA
<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 />©1988-2015 ACORD C
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />ttaganap
<br />63094029
<br />o_,, Rle LhtmtagL',nm4DlviefoR
<br />i+ REVIEWED&APPROVED BY:..
<br />IFS P, VMEP.1na,R1
<br />Risk ManagelnentAnalyst.
<br />
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