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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />03/27/2017
<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 terns 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
<br />AOn Risk Insurance Services West, Inc,
<br />Los Angeles CA Office
<br />CONTACT
<br />NAME:
<br />(AICNIJ . Ext): (866) 283-7122 FAXNo. ; 800-363-0105
<br />E-MAIL
<br />ADDRESS;
<br />707 Wi 1 shire Boulevard
<br />Suite 2600
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />Los Angeles CA 90017-0460 USA
<br />INSURED
<br />INSURER A: zurich American Ins CO
<br />16535
<br />5cs Enqineers
<br />3900 Kilroy Airport way, Suite 100
<br />Long Beach CA 90806-6816 USA
<br />INSURERB: steadfast Insurance Company
<br />26387
<br />INSURERC:
<br />INSURER D:
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 570065874162 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. Limits shown are as requested
<br />LTR
<br />TYPE OF INSURANCE
<br />D
<br />INgY
<br />WVD UULSK
<br />POLICY NUMBER
<br />MMIDDIYYYY
<br />EXP
<br />MMlDOfYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />GLO
<br />EACH OCCURRENCE
<br />$2,000,000
<br />CLAIMS•MADE OCCUR
<br />DAMAGE TO RENTET_
<br />PREMISES a occurrence
<br />$1,000,000
<br />MED EXP (Any one person)
<br />$ 25 , 000
<br />PERSONAL 8ADVINJURY
<br />$2,000,000
<br />GEH'LAGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$4,000,000
<br />POLICY[fl PRO-FX
<br />JECT
<br />PRODUCTS -COMP/OPAGG
<br />$4,000,060
<br />OTHER:
<br />A
<br />AUTOMOBILE LIABILITY
<br />BAP 0112780-02
<br />04/01/2017
<br />04/01/2018
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$2,000,000
<br />BODILY INJURY ( Per person)
<br />X ANYAUTO
<br />BODILY INJURY (Per accident)
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED AUTOS NON -OWNED
<br />ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Peracciden(
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />AGGREGATE
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEo I RETENTION
<br />A
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY Y) N
<br />ANY PROPRIETORIPARTNER /EXECUTIVE ❑
<br />OFFICERIMEMBER EXCLUDED? N
<br />(Mandatory in NH)
<br />NIA
<br />wC011277902
<br />04/01/2017
<br />04/01/2018
<br />X 3 ATUTE OTH-
<br />ER
<br />E.L. EACH ACCIDENT
<br />--
<br />$1,000,000
<br />E,L. DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />Irnys, describe under
<br />CESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />B
<br />Env Prof (E&0)
<br />IPR379235302
<br />D3/31/2017
<br />03 31/2018
<br />Per Claim
<br />$2,000,000
<br />Prof Liab - Claims made
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Job No. 90000016.01 Task 0000, Job Description: Environmental services. City of Santa Ana, its officers, employees, agents,
<br />volunteers and representatives are included as Additional Insured as required by written contract, but limited to the
<br />operations of the Insured under said contract, per the applicable endorsement with respect to the General Liability and
<br />Automobile Liability policies. General Liability policy evidenced herein is primary to other insurance available to an
<br />additional insured, but only to the extent required by written contract with the insured.
<br />& LVII"rt'VED BY: EUNICE HIE' EDIA (1:7ci 101= )
<br />CERTIFICATE HOLDER CANCELLATION i
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS,
<br />City of Santa Ana AUTHORIZED REPRESENTATIVE
<br />Attn: Marylin Booth
<br />20 Civic Centel, Plaza M-36
<br />Santa Ana CA 92702 USA
<br />01988-20.15 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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