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AI D® CERTIFICATE OF LIABILITY INSURANCE 1/10/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Greyling Insurance Brokerage 450 Northridge Parkway Suite 102 Atlanta GA 30350 CONTACT Jerry NO Ola NAME: y y IAIC.PHONE (']']0)552-4225 FAX No; (866)550-4082 ADDRIESS:Jerry.noyola@greyling.com INSURERS AFFORDING COVERAGE NAIL # INSURERA:Zurich American Insurance Co. 16535 INSURED POWER Engineers, Inc. 3940 Glenbrook Drive P.O. BOX 1066 Hailey ID 83333 INSURER B :BeazleyInsurance Company 37540 INSURER C: 37540 INSURER D: INSURER E INSURER F: COVERAGES OFRTIFICATF NIJMRFR-12-13 (PEI) RFVISInN NI IMFlI THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDDLICY/YYYY MMIDDY�Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 A CLAIMS -MADE FX] OCCUR L09265823-02 6/1/2012 6/1/2013 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICYFX PRO X LOC $ AUTOMOBILE LIABILITY (Ea accident) SINGLE LIMIT 1 000 000 BODILY INJURY (Per person) $LYNJURY A ANY AUTO Per accidentALL BODII$ ( )HIRED IR OWNED SCHEDULED AUTOS AUTOS AP9265821-02 6/1/2012 6/1/2013 AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIABOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LABCLAIMS-MADE DED I I RETENTION $ $ A WORKERS COMPENSATIONX WC STATU- OTH- I TORY AND EMPLOYERS' LIABILITY Y I N EACH ACCIDENT $ 1,000,0100 ANY PROPRIETOR/PARTNERIEXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA C 9265825-02 6/1/2012 6/1/2013 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, descnbe under - E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS below B Professional Liability 15U6G120401 6/1/2012 6/1/2013 Per Claim $5,000,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officers, employees, agents, volunteers & representatives are named as Additional Insureds on the above referenced liability policies with the exception of workers compensation & professional liability where required by written contract. The above referenced liability policies with the exception of professional liability are primary & non-contributory where required by written contract. Waiver of Subrogation is applicable where required by written contract & allowed by law. Separation of Insureds applies to theLi Policy. Should any of the above described policies be cancelled by t I}}i�eefore the expiration date thereof, we will endeavor to I IF wry I" nv"v�n q / / -� VANI.CLLA 1 IVIV City of Santa Ana Suzi Furjanic 20 Civic Center Plaza M-36 Santa Ana, CA 92701 AGUKU 25 (2010/05) INS025 rgmnn�I m `� eedy I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Laura Stitt THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Assistant Cit. Attorney ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE tias Ormaza/JERRY v �� ©1988-2010 ACORD CORPORATION. All rights reserved. Tho Arnion name and Innn aro ronia+arorl morlre of ACORr1