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Client #: 422
<br />LARRYWALK
<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE
<br />F DATE(MMIDDNYYY)
<br />03/25/2016
<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 />Dealey, Renton & Associates
<br />P. O. Box 12675
<br />Oakland, 94604 -2675
<br />510 465 -30099 0
<br />CONTACT
<br />NAME: Doris Chambers
<br />PHONE 510 465 -3090 FAX 51
<br />_ No, Ext : AIC, No): 0 452 -2193
<br />ADDRESS: dchambers @dealeyrenton.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Travelers Indemnity Co. of Conn
<br />25682
<br />INSURED
<br />Larry Walker Associates, Inc.
<br />Da Fourth Street, Suite 200
<br />Davis, CA 95616 -4124
<br />INSURER B: Travelers Property Casualty Co
<br />25674
<br />INSURER C American Automobile Ins. Co.
<br />21849
<br />INSURER D, Greenwich Insurance Company
<br />22322
<br />$300,000
<br />MED EXP (Any one person)
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 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 PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 />LTRR
<br />TYPE OF INSURANCE
<br />NSRL
<br />WVD
<br />POLICY NUMBER
<br />MM /DDY/YEYYY
<br />MM /DDIYYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ®OCCUR
<br />X
<br />X
<br />6803C998380
<br />04/01/2016
<br />04/01/2017
<br />EACH OCCURRENCE
<br />$2,000,000
<br />PREMISES Ea occur ence
<br />$300,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL & ADV INJURY
<br />$2,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY X ECOT [:] LOC
<br />GENERAL AGGREGATE
<br />$4,000,000
<br />GEN'L
<br />PRODUCTS - COMP /OPAGG
<br />$4,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />X
<br />BA3C999002
<br />04/01/2016
<br />04/01/2017
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />_(Per accident)
<br />$
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />X
<br />X
<br />CUP3C999260
<br />04/01/2016
<br />04/01/2017
<br />EACHOCCURRENCE
<br />$1 000000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$1 000 000
<br />_
<br />DED I I RETENTION $
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? ®
<br />NIA
<br />X
<br />WZP81031046
<br />04/01/2016
<br />04/01/201
<br />X PER -70TH-
<br />T -f IER
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />D Professional �P C003092706 04/01/2016 04/01/2017 $2,000,000 per claim
<br />Liability $4,000,000 annl aggr.
<br />E'WEVVc BY'" RUNIC I. 61E. EDP (F'G I OF � )
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />GENERAL LIABILITY POLICY EXCLUDES CLAIMS ARISING OUT OF THE PERFORMANCE OF PROFESSIONAL SERVICES.
<br />REF: Project Name: Santa Ana NPDES & Environmental Programs Fee Study; LWA Project No. 528.01. The City of
<br />Santa Ana, its officers, employees, agents, and representatives are named as Additional Insured to General
<br />and Auto Liability per policy form wording. Insurance is Primary and Non - contributory with Severability of
<br />Interest clause. Waiver of Subrogation applies to Workers Compensation coverages per policy form wording.
<br />Cancellation provisions are solely as shown on this certificate.
<br />L-K
<br />City of Santa Ana
<br />Clerk of the City Council
<br />P.O. Box 1988
<br />Santa Ana, CA 92702 -1988
<br />ACORD 25 (2014/01) 1 of 1
<br />#S1648555/M1648468
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />©1988 -2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />OTMP1
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