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An �e Digitally signed by <br />g Angie Acevedo <br />A r natc' 7f1JD nR 1 S <br />.44C � H 16:45:1 <br />CERTIFICATE OF LIABILITY I CE <br />-OFR3 MnWYVY) <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />AOn Risk Services Central, Inc. <br />Chicago IL office <br />CONTACT <br />NAME: <br />PHONE (866) 283-7122 FAX 800-363-0106 <br />INC. No. Erq: Alc. No.: <br />200 East Randolph <br />Chicago IL 60601 USA <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC IS <br />INSURED <br />INSURER A: Arch Insurance Company <br />11150 <br />Walsh Construction Company II, LLC <br />1260 Corona Pointe Court Ste 201 <br />INSURER B: Berkshire Hathaway Specialty Ins company <br />22276 <br />INSURER C: <br />Corona CA 92879 USA <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 570094871368 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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POUCYNUMBER <br />MMIODMlYY <br />MMmDIYYYY <br />CLINKS <br />A <br />X <br />COMMERCIALGENERAL LABILITY <br />Y <br />41PKG 90191 <br />EACHOCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE X❑OCCUR <br />SIR applies per policy ter <br />s & condi <br />ions <br />D MAGETORENTED <br />PREMISES desaccurrenw <br />$1,000,000 <br />MED UP (My one person) <br />$25,600 <br />PERSONAL& ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />GENERALAGGREGATE <br />$4,000,000 <br />POLICY ❑X �E T �% LOG <br />PRODUCTS - COMPIOP AGO <br />$4,000,000 <br />OTHER'. <br />A <br />AUTOMOBILE LABILITY <br />41PKG8901916 <br />ADS <br />06/01/2022 <br />06/01/2023 <br />COMBINED SINGLE LIMIT <br />flEa accident <br />$5,000,000 <br />BODILY INJURY( Per person) <br />A <br />X ANYAUTO <br />41CA88902016 <br />06/01/2022 <br />06/01/2023 <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED AMOS NON -OWNED <br />ONLY AUTOS ONLY <br />MA ONLY <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per accident) <br />B <br />UMBRELLALAB <br />X <br />OCCUR <br />47XSF30256807 <br />06/01/2022 <br />06/01/2023 <br />EACH OCCURRENCE <br />$10,000,000 <br />X <br />EXCESS LAB <br />CLAIM&MADE <br />AGGREGATE <br />$10,000,000 <br />DED1 <br />RETENTION <br />A <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LABILITY YIN <br />ANY PROPRIETORI PARTNER/ EXECUTIVE <br />N <br />41WC18910909 <br />06/01/2022 <br />06/01/2023 <br />X I PER STATUTE OTH- <br />E.L. EACHACCIDENT <br />$1,000,000 <br />OFFICEMMEMBER EXCLUDED? <br />(Mandatory in NH) <br />NIA <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />Yves, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addifional Remarks Schedule, may be attached it more space is required) <br />RE: Lease Agreement between The City Of Santa Ana and Walsh Construction company II, LLC for use of property located at 1000 <br />East Santa Ana Boulevard in the City of Santa Ana - Santa Ana Regional Transportation Center (SARTC), suite 200 and portions of <br />the parking area not presently occupied. Walsh Project: OC Streetcar Construction - Project IFB 7 - 1904, job No.: 218132. See <br />attached. <br />CERTIFICATE HOLDER CANCELLATION -'9 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE MTH THE <br />POLICY PROVISIONS. <br />City of Santa Ana <br />Public works Agency <br />Attn: Executive Director Of <br />Public Works Agency <br />20 Civic Center Plaza (m-21) <br />Santa Ana CA 92701 USA <br />©1988-2015 ACORD CC <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />Ride Managenlmt Df vision <br />REVIEWED6APPROVED BY: <br />" A-f4 Au444e <br />Risk Management Spedahl t <br />