KAPSCH TRAFFIcCOM TRANSPORTAITON NA, INC. (FNA SCHNEIDER ELECTRIC MOBILITY NA, INC. 3b - 2016

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AC<:>R Qr CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/29/2017 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or 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 JLT Specialty USA Y - 135 Main Street Suite 1600 San Francisco, CA 94105 CONTACT NAME; Darya Kavalenka PHONE FAX -(A/C. o E 415 805-8857 , No): E-MAIL ADDRESS: Darya,Kavalenka ltus.com INSURERS AFFORDING COVERAGE NAICH www.jltre.com California License: OH01656 iNsuRERA: AXA Insurance Company 33022 INSURED sch TraffiCCom Holding II US Corp. Kapp1 INSURERS: Great Northern Insurance Company 20303 INsuRERc: Chubb Indemnity Insurance Company 12777 820Greensboro Drive Suite 1002 McLean VA 22102 INSURERD: INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: Sc1RFion Fd REVISION NI IMRFR• 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 INSO SUER' WVD POLICY NUMBER POLICY EFF POLICY EXP (MMIDDNYYYI LIMITS A ,/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑✓ OCCUR PCS003157(17) 11/30/2017 7/1/2018 EACH OCCURRENCE $1000000 PREMISES Ea oculrrence $1 000 000 MED EXP (Any one person) $ 10 000 PERSONAL & ADV INJURY $1 000 000 AGGREGATE LIMITAPPLIES PER: POLICY Z jEO- El LOC GENERAL AGGREGATE $2,000,000 GEN'L PRODUCTS - COMP/OPAGG $2000000 ✓ OTHER: EBL Deductible: $1,000 Em to ee Benefits E&O $1 000 000 B AUTOMOBILE r LIABILITY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY (17)73565101 11/30/2017 7/1/2018 Eo eBIINdE�DISINGLE LIMIT $ 1 000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Par acelde l $ $ A �/ UMBRELLA LIAO ,/ OCCUR X8003158(17) 11/30/2017 1/1/2018 EACH OCCURRENCE $5000000 EXCESS LIAR CLAIMS -MADE I AGGREGATE $ 6 000,000 DED I /I RETENTIONS 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory In NH) OF OPERATIONS below It yea, describe DESCRIPTION OF O NIA (17)71751328 11/30/2017 7/1/2018 _ STATUTE �RH E.L. EACH ACCIDENT $ 1 0DQ 000 E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Santa Ana, PWA - Transportation & Traffic Engineering Department are are Included as additional Insured (except for Workers Compensation) where required by written contract. Waiver of Subrogation Is applicable In favor of City of Santa Ana, PWA - Transportation & Traffic Engineering Department on the General Liability, Auto Liability, Umbrella Liability, and Workers Compensation where required by written contract. Additional Named Insured(s): Kapsch TrafficCom Transportation NA, Inc. REVIEWED BY: EUNICE HEREDIA (PG I OF ) VMIYVLLLM City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Citn: Vinh t Nguyen, P.E. Sr. Civil Engineer THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y I 9 ACCORDANCE WITH THE POLICY PROVISIONS. PWA - Transportation & `traffic Engineering 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE , / l,1,p•- I Matt Rush ��LV� ©1988-2015 ACORD CORPORATION. All rinhfs ra¢arvarl ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 39659054 1 17-18 - GL AU UMB WC I Darya Kavalenka 1 12/29/2017 11:56:22 AN. (PST) I Page 1 of 2