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ACORU0
<br />CCO CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DDIYYYY)
<br />17/20/2017
<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 be endorsed. 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 />PRODUCER
<br />MHBT, a Marsh & McLennan Agency, LLC company
<br />8144 Walnut Hill Lane, 16th FI
<br />Dallas TX 75231
<br />NT
<br />NAMEACT Stacy Brimer
<br />PHONE 972 770-1638 FAx
<br />we No 972-376-8108
<br />-MAIL • Stacy_brimer@mhbt.com
<br />EADDR
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />INSURER A: Hartford Casualty Insurance Company
<br />46UUNLJ3272
<br />INSURED HUITTZOL
<br />-29424
<br />Insurance Company 20281
<br />Huitt-Zollars, Inc.
<br />1717 McKinney Ave., Ste. 1400
<br />Dallas TX 75202-1236
<br />-INSURERB:Federal __
<br />INSURER C:
<br />INSURER D :
<br />INSURER E
<br />INSURER F:
<br />COVFRAGFS CFRTIFICATF NIIMRFR- 1841592319 RFVIRION 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 HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSRR
<br />TYPE OF INSURANCE - --
<br />-1NSD
<br />D
<br />-- POLICY NUMBER -
<br />POLICY
<br />M DID�YY
<br />MMIDp YYY
<br />---- - LIMITS - -
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />46UUNLJ3272
<br />6/1/2017
<br />6/1/2018
<br />EACH OCCURRENCE $1,000,000
<br />AMAGCLAIMS-MADE
<br />PREMISES Ea occurrence $300,000
<br />X� OCCUR
<br />MED EXP (Any one person) $10,000
<br />PERSONAL & ADV INJURY $1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $2,000,000
<br />POLICY � PE� F`X1 LOC
<br />PRODUCTS - COMP/OP AGG $2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />46UENPBO920
<br />6/1/2017
<br />6/1/2018
<br />Ea accident LIMITOMBINED SINGLE $1,000,000
<br />BODILY INJURY (Per person) $
<br />X
<br />ANY AUTO
<br />X
<br />AUTOWNED SCHEDULED
<br />AUTOS
<br />NON -OWNED
<br />AUTOS
<br />HIRED AUTOS 1:
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />Per accident
<br />X
<br />Coll $1,000 X Comp $1,000
<br />1$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />46XHURJ8271
<br />6/1/2017
<br />6/1/2018
<br />EACH OCCURRENCE $10,000,000
<br />AGGREGATE $10,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED I X I RETENTION $10,000
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />R/EXECUTIVE ❑
<br />ED? ANFICER/MEMBER EXCLUDED? N
<br />EXCLUD
<br />N / A
<br />46WEA04105
<br />6/1/2017
<br />6/1/2018
<br />X PER OTH-
<br />PERER
<br />E.L. EACH ACIDENT ,000,000
<br />E.L. DISEASE CEA EMPLOYE 000,000
<br />(Mandatory in H)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />-
<br />E.L. DISEASE - POLICY LIMIT $1,000,000
<br />A Hired Car Physical Dam: $100,000 46UENPBO920 6/1/2017 6/1/2018 Hired PD Comp/Coll Ded $1,000/$1,000
<br />B Employee Theft 82241508 6/1/2017 6/1/2018 Employee The Limit: $1,000,
<br />A Valuable Papers 46UUNLJ3272 6/1/2017 6/IJ2018 Valuable Papers Limit: $25,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Rem REVIEWED BY: EUNICE HEREDIA (PG OF 7k)
<br />Additional Insured form #HG0001 edition 06/05 applies to the General Liability policy.
<br />Waiver of subrogation form #CG2404 edition 05/09 applies to the General Liability policy.
<br />Primary & Non -Contributory General Liability form #HG0001 edition 06/05.0
<br />Additional Insured form #HA9916 edition 03/12 applies to the Automobile Liability policy.
<br />Waiver of subrogation form #HA9916 edition 03/12 applies to the Automobile Liability policy.
<br />See Attached...
<br />CERTIFICATE HOLDER CANCELLATION
<br />C 1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana Public Works Agency, its officers,
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />employees, agents, Volunteers and
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Representatives
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 97201
<br />C 1988.2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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