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"CC>R ild® CERTIFICATE OF LIABILITY INSURANCE DATE I 3/18/2014 ' 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(les) 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 JerryNO Old NAME: Y _ PHONE (770)552-4225 F� N (866)550-4082 a pAILSS,jerry.noyola@gryeling.com INSURERS AFFORDING COVERAGE NAIC q INSURER A National Union Fire Ins Cc 19445 INSURED POWER Engineers, Inc. J�_ 3940 Glenbrook Drive A�(b/.�A-D b�{7 P.Q. BOX 1066 Hailey ID 83333 INSURERB:NBw Hampshire Insurance Company 26247 INSURER c:S ndicate 2623/623 at Lloyd's INSURER D: INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 (PEI) REVISION NUMBER: 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. HIER LTR rypE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM DD POLICY EXP MM DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7XOCCUR 3L 5094741 4/1/2014 4/1/2015 DAMAGE TO RENTED ERFMI Ea accurrenca $ 500,000 MED EXP (Any one person) $ 25,000 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 POLICY X PFPT RO- POLICYLOC $ AUTOMOBILE LIABILITY COBINEDt SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ A A X X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTNONOOWNED HIRED AUTOS X AUTOS A 6403759 (AOS) A 6403760 (NA) 4/1/2014 4/1/2014 4/1/2015 4/1/2015 BODILY INJURY (Par accident) $ PROPERTYDAMAGE $ LIABOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ IAUMBRELLA WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE [K OFPIC"MEMBER EXCLUDED? In NH) NIA C 049901174 (AOS) C 049901175 (CA) 4/1/2014 4/1/2014 4/1/2015 4/1/2015(Mandory X WCSTATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYE $ 1 000 000 If yes, describe under DDESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ 1 000 000 C Professional Liability 13B97140201 4/1/2014 4/1/2015 Per Clair $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. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' written notice (except 10 days for nonpayment of premium) will be provided to the Certificate Holder named below. y00 CERTIFICATE HOLDER T4b ` . CANCELLATION r^r City of Santa Ana N,,k`0((O'y Purchasing Department, St51a� .✓ 7 / 20 Civic Center Plaza PS ✓" d SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE / Santa Ana, CA 92701 David Collings/JERRY ACORD 25 (2010/05) INS025ron nnslm © 1988.2010 ACORD CORPORATION. All rights reserved. Tho Ar.npn name and Innn arc ronictcrod mor4c of ACrTRn