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A " CERTIFICATE OF LIABILITY INSURANCE Dm Y)
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<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 NTA T
<br />NAME: Laura OaS
<br />Construction Risk Solutions, TLC PHONE FAX
<br />11311 McCormick Road LAC N Ex - - A/C No: 443 -798- 72 90
<br />Suite 450 ADDRRESS:Certificates@thecrsteam.com
<br />Hunt Valley MD 21031-8622 PRODUCER
<br /> CUSTOMER ID #:
<br /> INSURERS) AFFORDING COVERAGE NAIC#
<br />INSURED INSURERA:New Hampshire Insurance Oo 23841
<br />Structural Group, Inc.
<br />
<br />7455-T New Rid
<br />e Road INSURER B: National Union Fire Ins Co Pittsbur 19445
<br />g
<br />Baltimore, MD 21076 INSURERC:Catlin Specialty Insurance Company 19518
<br /> INSURERD:XL Specialty Insurance Company 37885
<br /> INSURER E
<br /> INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 155663616 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
<br />PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
<br />WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT
<br />TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />NSR
<br />LTR
<br />TYPE OF INSURANCE ADDL
<br />SR SUBR
<br />VAD
<br />POLICY NUMBER POLICY EFF
<br />MMIDDIVYYV POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />B GENERAL LIABILITY 2449508-01 7/1/2012 7/1/2013 EACH OCCURRENCE $2,000,000
<br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $1,000,000
<br />
<br /> CLAIMS-MADE OCCUR MED EXP(Any one parson) $5,000
<br /> PERSONAL &ADV INJURY $2,000,000
<br />
<br /> GENERAL AGGREGATE $4,000,000
<br />
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $4,000,000
<br /> POLICY X PRO- X LOC $
<br />S AUT OMOBILE LIABILITY 3506359-01 7/1/2012 7/1/2013 COMBINED SINGLE LIMIT $2
<br />000
<br />000
<br /> X (Ea accident) ,
<br />,
<br /> ANYAUTO BODILY INJURY (Per person) $
<br /> ALL OWNED AUTOS
<br />SCHEDULED AU
<br />OS BODILY INJURY (Per accident) $
<br /> T PROPERTY DAMAGE
<br />$
<br /> X HIRED AUTOS (Per accldenl)
<br /> X NON-OWNED AUTOS $
<br />
<br />D X UMBRELLA LIAB X OCCUR US00062096LI12A 7/1/2012 7/1/2013 EACH OCCURRENCE $10,000,000
<br /> EXCESS LIAB CLAIM&MADE AGGREGATE $10,000,000
<br /> DEDUCTIBLE $
<br /> X RETENTION $10,000 - $
<br />A WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITV 015883713-01 7/1/2012 7/1/2013 X TWO STATIC OTH -
<br />OR, _IM T? I
<br /> YIN
<br />ANY PROPRIETCRIPARTNEMEXECUTIVE
<br />?
<br />OFFICER/MEMSER EXCL
<br />DED
<br />
<br />N/A
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br /> U
<br />?
<br />(Mandatory In NH) E.L. DISEASE - EA EMPLOYE $1,000,000
<br /> If yes, describe under
<br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000
<br />C Professional Liability CPL95994-0713 7/1/2012 7/1/2013 Per Occurrence $5,000,000
<br /> Per Aggregate $5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
<br />Re: City of Santa Ana - Fiesta Market Place Parking Structure PT Repair
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as
<br />See Attached...
<br />CERTIFICATE HOLDER --- -""" ""CANCELLATION 30 days/10 days fnr nnn-navment
<br />
<br />
<br />f,? SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
<br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
<br />
<br />L
<br />4 CCORDANCE WITH THE POLICY PROVISIONS.
<br />aUTa St t
<br />City of Santa Ana h
<br />Ce y
<br />20 Civic Center Plaza St; AM ity Attorney
<br />Santa Ana CA 92702-1988 AUTHORIZED REPRESENTATIVE
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<br />©1988-2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
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