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Client#: 1260332 305ECOI+iOGRO <br />DATE=. (MwoomYn <br />ACORD- CERTIFICATE OF LIABILITY INSURANCE 04/27/2012 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORM N ONLY A D F S RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THEN THE 18SU NG NSUR . S), AUTHOLRMED <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT STITUTE A CONTRACT �E <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICHOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(i63) must be end: orsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />CONTA <br />PRODUCER NAME: <br />6681T Insurance Services I (° Eg; 714 578 -7000 Alc, No <br />AIL <br />of Orange County aooRESS_ _- __.— _------- __ - - -- -- -- <br />f----- F2674 680 Langsdorf Drive Suite 100 (NSURER(S) AFFORDING COVERAGE Fuller url, C►. X2831 logs €'rupoiy (casualty Co tNSUREQ INSURER B : Liberty Insurance Un.! irwriters Aegis ITS, Inc. (� ,RERc ; RSUi Indemni Com an <br />rust _'_ x -- <br />3360 E. i_a Palma Ave. t — <br />INSURER D <br />Anaheim, CA 92806 a00Of "� INSURER E: <br />N2URER F; <br />COVERAGES CERTIFICATE NUMBER: .��o -• _____ <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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE tCPY 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 />..— .._._.__ p�LICY EFF POLICY EXP— T - -_ —_ U _ <br />lNSR AO 6 POLICY NUNBER I (NM1ODMYY MMlDOIYYYYii —_- rar5 <br />T�7� OF fN.4tJRANCE I R VfVD — <br />LTR �.---_- 7/2012 01!27/201 F•acwoccuRRENCE $1,000,000 <br />NERAL 1;ASI LITY 16303193N600TIL12 /2- <br />{, COMMERCIAL GENERAL LIABILITY <br />CIA',.v.s.;v GE n OCCUR <br />GEN-L AGGREGATE LIMIT APPLIES PER: <br />f ._ .� PRO - -- , <br />-'P C'i L__ . ,_SECT —1 �0= <br />A AUTOMOEIL F t 1 11311- TY <br />XI ANY AUTO <br />7 ALL O\NNE? CHEDULED <br />I__� AUTOS — NOtJ -0WNEO <br />1�� ,IRED AUi OS X AUTOS <br />8103193N600TIL12 <br />g X� I)M3RF LA uAB X occuR UMBLA2559181 <br />EXCESSLJAB .._ CLAIMS -MADE j <br />�-1-- --- T- <br />-_. <br />OED __i RFTENI IONS I <br />WORKERS Co11TF �XSIITION U B9501 BO9612 <br />A AND EMPLOYCRS' LIABILITY Y! N <br />ANY PROP RIE7 ORIFART NER/EX "CUTIVE❑ INIA <br />OFFICERIMEMBER EXC�_UDEO9 <br />tuwwatory In NH.' <br />if vas— ies:n`.a "; *'d r <br />C (Auto Excess <br />Liability <br />NHA230367 <br />i ME-j:' tXP (Any one Person) I. D <br />I= �.:;7NALH AOV INJURY S1 <br />PRODUCTS. COMPIOP AGG $ 2 <br />S <br />94/2712012 041271201 � NdEe�tSINGLE LIMIT 51 <br />"4-It <br />soon.Y INJURY (Per person) $ <br />P�BODILY INJURY (Per accident) S <br />OPERTY DAMAGE $ <br />Pg� e�id�`I - <br />$ <br />9412 12012 (Ai27/2013! E,-.(:F OCC_JRRENCE $i <br />I � $ <br />aru- OT+ <br />42712012 04/27/2013 X l Q _ - <br />E.L EACH ACCIDENT 151 <br />E.L. DISEASE - EA EMPLOYEE $1 <br />El '31 SENSE - POLICY LIMIT 1 $1 <br />$5 ,;f0i),000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks S;N wq, if mow space is required) <br />Certificate Holder is added as Additional Insured per policy form #CGD2470805 & Waiver of Subrogation <br />per policy Sol-in #CGD4581008 both a part of policy #6303193N600TIL12. <br />Certificate Holder is amended to read: The City, its officers, employees, agents, <br />volunteers and representatives <br />RE: Traffu $#iprai 5ustem, Advanced Traffic Management System, and Street Light System Maintenance in and <br />for the City of Saiita Ana. L � I; o i- LJ -'i 10 t [ 4 1 u <br />SHOULD ANY OF THE ABOVE D£S-;ftiFiEJ POLICIES BE CANCELLED BEFORE <br />City of Santa Ana �, //' i E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Affin: V•tnh Nguyen ACCORDANCE WITH THE POLICY PROVISIONS. <br />P.FJ. Box 1988 / Lib043 Lr <br />c�.il:"1!d Ane, CA 42702 -1988 t A' t1TFfoRIZED REPRESENTATIVE <br />C 1988 -2010 ACOR.0 CORPORATION. All rights reserved., <br />ACORD 25 1 of 1 The ACORO name and logo are registered m -irks of ACORD <br />#S854386dAi85d3853 CLRAG <br />