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A� " CERTIFICATE OF LIABILITY INSURANCE
<br />DATE/(MMIDO 8 )
<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 />Cavignac & Associates
<br />450 B Street, Suite 1800
<br />San Diego CA 92101
<br />CONTACT
<br />Certificate Department
<br />PHONE FAX
<br />A/c No Ext: 619-744-0574 a/c No:619-234-8601
<br />ADMDARESS: certificates@cavignac.com
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />A
<br />INSURERA: Valley Fore Insurance Company 20508
<br />Y
<br />INSURED NV51NCO-01
<br />NV5 Global, Inc.
<br />9890 Irvine Center Drive
<br />INSURER B: Continental Casualty Co. 20443
<br />INSURER C: Continental Insurance Company 35289
<br />INSURERD: National Fire Ins. Hartford 20478
<br />Irvine, CA 92618
<br />INSURER E: Berkley Insurance Company 32603
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 2057710534 REVISION NUMRFR-
<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 CONTRACT OR 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MMIDD/YYYY
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />Y
<br />Y
<br />6057040530
<br />5/1/2016
<br />5/1/2019
<br />EACH OCCURRENCE $1,000,000
<br />DAMAGE T O RENTED
<br />PREMISES Ea occurrence $1,000,000
<br />X Cross Liab/Sevin
<br />MED EXPAn
<br />t Y one person) ) $ 15,000
<br />X $0 Deductible
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICYFX] JE� D LOC
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS - COMP/OP AGG $ 2,000,000
<br />Stop Gap Liablli $1,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />6057040575
<br />511/2018
<br />5/1/2019
<br />COMBINED SINGLE LIMIT
<br />Ea accident $1 000 000
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />JURY Per accident
<br />( ) BODILY IN $
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />Per accident $
<br />C
<br />X
<br />UMBRELLA LIABX
<br />OCCUR
<br />6057187219
<br />5/1/2018
<br />5/1/2019
<br />EACH OCCURRENCE $ 20,000,000
<br />AGGREGATE $ 20,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION$o
<br />$
<br />D
<br />WORKERS COMPESATION
<br />AND EMPLOYERS' LIABILIITY Y / N
<br />Y
<br />6D57040558
<br />5/112018
<br />5/1/2019
<br />OT -
<br />X I STATUTE ERH
<br />EACH ACCIDENT $ 1,000,000
<br />ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.
<br />OFFICER/MEMBER EXCLUDED' �
<br />N / A
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />E
<br />Professional Liability
<br />AEC902036802
<br />5/1/2018
<br />5/1/2019
<br />Each Claim $10,000,000
<br />Aggregate $20,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Re: RFP # 16-080 &17-034; Delhi Channel Diversion & Walnut pump Station projects. Additional Insured coverage applies to General Liability and Automobile
<br />Liability for City of Santa Ana and their officers, agents and employees per policy form. Primary coverage applies to General Liability per policy form. Waiver of
<br />subrogation applies to General Liability, Automobile Liability, and Workers Compensation per policy form. If the insurance company elects to cancel or
<br />non -renew coverage for any reason other than nonpayment of premium they will provide 30 days notice of such cancellation or nonrenewal. Professional
<br />Liability - Claims made form, defense costs included within limit. Excess/Umbrella policy follows form over underlying policies: General Liability, Auto Liability &
<br />Employers Liability (additional insured and waiver of subrogation apply).
<br />REVIEWED BY:EUNICE HEREDIA (PG OF -11
<br />t,r_m i mam i s nULL)CM GANI:tLLA I IUN
<br />City of Santa Ana, Public Works
<br />20 Civic Center Plaza
<br />Santa Ana CA 92702
<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 />U 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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