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OCEAN BLUE ENVIRONMENTAL A- 20013 -115 -fit H.EVIE"rVED BY
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<br />X""' -- EUNIQ.,VEf= EDIIA(PG 1 OF 16)
<br />CE..RTIFICA`�E.. OF LIABILITY [I���R.'��JCE
<br />t7A'E7 IYYYY,
<br />TO WHICH THIS
<br />a/22e� ®15..
<br />22120
<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(les) 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 lielr of such endorsement(s).
<br />PRODUCER
<br />CONTACT Nanc'Assen a
<br />y g
<br />Commercial Linos - (818) 464 -9300
<br />PHONE PAx ..
<br />A!C No E t1;, 1'( -464 938Ei APG' Nb :B66- 475 °9866
<br />Wells Fargo Insurance Serv{ces, Inc. _ CA Licit: OD08408
<br />E•M li a.cam _
<br />ADDRESS. nanC _ a..a—ssP--n a — — vel—lsia_.r - -
<br />15303 Ventura Boulevard, 7th Floor
<br />_
<br />CLAINIS•MAOF. ® OCCUR
<br />INSURERS AFFORDING COVERAGE
<br />NAIL N
<br />Sherman Oaks, CA 91403 -3197
<br />�-
<br />INSUFtERA: Starr SLIrpIUS Lines IDS. CO.
<br />...
<br />13604
<br />INSURED
<br />INSURER B a Starr Indemnity and Liability Company
<br />38318
<br />Ocean Blue Environmental Services., Inc.
<br />INSURER C : Federal, Insurance Company
<br />2028'1
<br />925 West Esther Street
<br />GENFRAL AGGREGATE,
<br />INSURER ne
<br />INSURER E:
<br />..m.........._
<br />PGL.fCY JECT LOC
<br />Lang Beach, CA 90813
<br />INSURER F
<br />2,000,000
<br />COVERAGES CERTIFICATE NUMBER- 9379327 REVISION NUMBER: See below
<br />THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TG THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
<br />TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
<br />TERMS,
<br />EXCLUSION'S AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />. __
<br />F'ptoe EIFF POLICY ExP
<br />11N.T4 TYPE OF INSURANCE R POLICY NUMBER MMtUeYMYYY MMIODPYYYY
<br />..
<br />LIMITS
<br />_....-
<br />x COMMERCIAL GENERAL LIABILITY
<br />A 10000657137151 07 101 12015 07/01/20,16
<br />EACH OCCURRENCE
<br />$ .
<br />1.000,000
<br />ORE _.. _
<br />_.
<br />_$
<br />CLAINIS•MAOF. ® OCCUR
<br />&'REMISES Ea accwrrenCe �.
<br />REMIS
<br />_
<br />50,000
<br />M EXP (Anyone person)
<br />$
<br />6,000
<br />PERSONAL & A INJURY
<br />$
<br />1,000,000
<br />GEN L AGGREGATE LIMIT APPLIES PER:
<br />GENFRAL AGGREGATE,
<br />%� PRO-
<br />..m.........._
<br />PGL.fCY JECT LOC
<br />PRODUCTS - COMP /OP AGO
<br />$
<br />2,000,000
<br />X. OTHER: SIR; $20,000
<br />$
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />SISIPCA08268415
<br />07/01/2015
<br />071011201.6
<br />COM&INEDSWGLL LIMI 1
<br />iEa uccidenl
<br />$
<br />1,000,000
<br />iBODILY INJURY (Per person)
<br />X
<br />AINY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />80011-Y INJURY (Per accident)
<br />X
<br />X NON OWNED
<br />PROPERTY DAMAGE .
<br />'......
<br />HIRED AUTOS AUTOS
<br />Per ac6danl
<br />MCS -9a
<br />$
<br />UMBRELLA LIAB
<br />X'. OCCUR
<br />1000336613151''.
<br />07/0112015
<br />07/0.1/2016
<br />EACH OCCURRENCE
<br />$
<br />9,000,000
<br />AGGHLBk] L
<br />$
<br />9,000,000
<br />X
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DE:D I I RETENTION $
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />004 472796400
<br />0710112015
<br />07/01120'16
<br />X
<br />�, arnH
<br />usLSa1
<br />AND EMPLOYERS' LIABILITY YIN
<br />°. _sTATaIT� ,,..
<br />ANY PROPRIETOWPARTNEWE EXECUTIVE
<br />F.L. EACH ACCIDENT
<br />$
<br />1 000,000
<br />OFFICERIMEMBFR EX.CLUD Dt
<br />kJ IA
<br />E.L. USE SE - EA EMPU)YF'�..
<br />$
<br />._.....
<br />1 000,000
<br />IMandalory in NH)
<br />byes, describe under
<br />F.4 DISEASF - POUCY LIMIT
<br />$
<br />1,000,00 �
<br />DESCRIPTIOI +I' (3F OPERATION'S below
<br />A
<br />Pollution Ualaility
<br />1000065767151
<br />07101/2015
<br />07101/2016
<br />Umlls: $1,04101000 Each Occurrence
<br />Dad :$20,000; Occuronce Form
<br />DESC.RIP11ON OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 161, Additional Remarks Schedule, may be attached xt morn nyaace, Is recinlred)
<br />RE:Contract# A -2013- 115 -02 Cortliicate Holder is named as a;dditlonal insured as required by written contract,
<br />City of Santa Ana
<br />Attn: Public Works Department
<br />20 Civic Center Plaza M -36
<br />Santa Ana, CA 92701 -0000
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFURE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORI2ED REPRESENTATIVE
<br />9(4 _
<br />Fhe ACORD name and logo are registered marks of ACORD
<br />ACORD 2.5 (2014101)
<br />(IN. 93501n4lxsvad m 7lPdfit0.16,y
<br />@ 1988 -2014 ACORD CORPORATION. All rights reserved,
<br />
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