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Jonnson-i-ranK & HSSOCIateSe Inc. <br />On -Call Construction Surveying Services RFP No. 19-090 <br />Santa Ana Public Works Agency <br />A eoc oe CERTIFICATE OF LIABILITY INSURANCE <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 certiDwle holder Is an ADDITIONAL INSURED, the poll y(les) must have ADDITIONAL INSURED provisions or be endonad. <br />H 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 nBhte to the certificate holder In lieu of auch r ndi nementhil. <br />PRODUCER CA IOSUfBnCe S2NCBS <br />CT <br />XA"3Ie Betty Tran <br />IN Vantls, Suite 250 <br />A uct Viejo, CA 9265E <br />PONE FAX <br />qe, Ex0: 949-297.5962 (A,o, Ni949-297-5950 <br />EN R. <br />ANDRESS: berry.lrm@sNUsa. COm _ <br />INWRERIS)AFMADINGCOVERAGE Ni <br />www.wausa.mm CA Liwnee OOE67768 <br />INSURM A: RLI Insurance Company 1305E <br />uninued <br />_ <br />Johnson -Frank 8 Associates, Inc <br />....RB' <br />5150 E. Hunter Avenue <br />xsaflEfl o: _ <br />Anaheim CA 92807 <br />INURERE' <br />xa"RPA IF <br />COVERAGES CERTIFICATE NUMBER: 4sRBREBR REVISION NIIMRFR- <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 HOVE BEEN REDUCED BY PAID CLAIMS <br />INamR Core OF INSURANCE POLRYNUMSM YVn NIgr�D YE"YPY UNITE <br />A .. ✓ caxLaRaALGesEnuueelLnr ✓ PSS0001301 12J112018 1211nO19 EAC„OCCURRENCE 11,000000 <br />u4w.AwDF ✓1occlm Scheduled Al Endt ffir SLEa orm, s1.000,W0 <br />aPP83130212 -- - - <br />PrlmMonCon MFDEXPI si 31o00D <br />Professional Services <br />✓. War of Subr I peHonnetl by the Insured PFR$ONALaAW xn_av_31.000000 <br />GENLAGGREWTEUNITAPPLGSPER are E%GUdad gp9uw;acgrlcGAre <br />_F2.00o,0t10 _ <br />_POLICY V PIE"CT ✓ LOG PRODUcrS.COMPRWA00 s2.000000 <br />OmER s <br />A Amoeoawu.Wmrt <br />✓ ✓ PSA0001078 121tn018 <br />12/12018 sT.000000 <br />ANY Auto <br />Daugnaled insured Entll <br />_=INxEUaU <br />eoORrlruwvlP. vr+>ml 3 <br />ONNEU SWEOULEO <br />:ICA20,181013, Pnm/NonCol <br />_ UIn3 ONLY _ AVI03 <br />and BIM War of Subr <br />gOOILY nLIIALY jPerettipmll 3 <br />'HIREn NON-0NMEn <br />J uTos ONLY ✓, Aurmsmi <br />Included on pg2 of Form <br />OPERTY <br />PRpAAC ME S <br />IPgr --•aal <br />PfImMonCon V Wvr of Subr <br />I i1PPA300W13 <br />s <br />A VueaELIALws ✓ OCCUR PSEDD01230 12Jf2018 <br />:12/1n019 EIGHODGURRENCE 14_000000 <br />✓ "Does Cue cL,Ns.„N„F Excuues Professional <br />_ <br />iAGfflEWTE sq 000000 <br />DED RETFxrIONs Liability-- <br />A NeAnw ✓ PSW0002288 12/12018 <br />12l1n019 ✓ caH <br />ANOWRLwMA <br />y/N WENBr OI SIII)rOgaIIM <br />-_BER ATUM . <br />INnfNPLOYERe'WeelrY <br />ANYFROFRIEiOWPPATNEREREGN'IYE <br />GFHCENNEMew ExcLucErn �Y NIA Endt NWC040306DIEF. <br />EL EACH ACCIDENT r1-000'" <br />_. <br />(Yandabyh NX) <br />EL MIDU E-EAEMPLOYCE -11000.000. <br />IIY- Yea"eb.L. <br />DESCRIPTION OF OPEPAn9NEhlrr <br />ELDIGu-POUCYLIMII a1.0000oD <br />A Prlsfexani Liability RDP0034448 12/1n018 <br />12l1n019 52,000.000 Each Claim <br />Cla,.Made <br />32,000.000 Aggregate <br />DncfllPrrox aPovERAnaxalLocpnoxs rvwlcLes iacoRD uT.Anxuenn Mmem. xnax,Ia. may m eneFlX4emaaapea x xnA.el <br />Certificate Helder is an Additional Insured with respect to G rneral Liability (CL) and Automobile Liability but only when required by wimen centred <br />with the Insured pdorm an occurrence as per Endorsements noted above. GL includes Separation Df Insureds and Contractual Liability per limitations <br />in the BusinenOwnem' Coverage term. A Workers Cwpanselion Waiver of Subrogation as noted above is included ter the person or organkatOn named <br />in the Schedule that an parties to a contract requiringg Ihis Endorsement, provided that mnlnct is executed baron the loss. Coverage m <br />subject all <br />policy terms, conditions, limitations and exclusions. 3U Day NOOoe of Cancei Days for Nan -Payment in accordance with Policy prwisons. <br />CERTIFICATE HOLDER CANCELLATION <br />RFP 17-009 and Agteemenl AA-2011-09BJRA-20A-159 <br />Clly of Santa Ana, its officers and employees <br />PaBOX 1988 M-35 <br />Santa Ana CA 92702 <br />SHOD MAW Of THE ABOVE DESCRIBED POLICIES BECANCELLEO BEFORE <br />THE EXHRATION OATS THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PBOWSIONS. <br />AUnI°RIZEa PEPflEEENipiIVEii��p/� <br />VC AIIae K, 1 ram �xFh <br />C 1988-2015 ACORD CORPORATION. All rights reserYW- <br />ACORD 25 (20161031 The ACORD name and logo an ragtetered marks of ACORD <br />5150 E. Hunter Ave. 35 Anaheim. CA 92807 <br />(714) 777-8877 alanfrank@johnson-frank.com FAX: (714) 777-1641 <br />