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<br />CERTIFICATE OF LIABILrrY 1MSl1RARM
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<br />THIS CERTIFICATE IS ISSUED ASA 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 BYTNE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINGMSURER(S),AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />NT: If Che WAIVED, holder is an ADDITIONAL INSURED, the poilcy(los) must have ADDITIONAL INSURED Provislonsarboendorsed.
<br />If SUBROGATION
<br />If SUBROGATION Is WAIVED, sub(ect to the terms and aantlftlgns of the policy, certain P011cies may require an endamemum, A statement on
<br />this certificate does not eonfor rl hts to the cartlficate holder In Ilan of such endorsement s .
<br />Paoouaen Liconso#0E67768
<br />c OT Elizabeth leach
<br />La ends Environmental Ins. services
<br />190 Vantls
<br />Suite 250
<br />Aliso Viejo, CA 92666
<br />FRONK _
<br />No, ria,e ti (949} 297.5637 62011 1kic, uab(949 297.5960
<br />E' all • , Eliza beth.Leachi@laausa.cem _
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<br />INSURED
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<br />INSUR'uRA•GIUm&FOfBtnr 6p6CI01t`IpSUraOCe Gdm Dano $2Q
<br />N6U E, B;TYUm UlI 1 3 aQCa GbmDRnv 7120
<br />INSURER 1tar5tone•N�ltional in L once Company 2548
<br />Rincon Consultants, Inc,
<br />210 N Ashwood Ave
<br />Ventura, CA 93099-
<br />INSURER
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<br />AUTOMODUCLIAMUTY
<br />X ANY AUTO
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<br />TH151S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REOUREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWtTH 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 REDUCEC BY PAID CLAIMS,
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<br />INSRT Type OF INSURANC ADaL eUaft� P C POLICY a%P "
<br />Urn6 1 POLICY NUMaER LIIAIY9
<br />A X COM
<br />—I I EACH U x S 31060,008
<br />WRASAIADNFRALLIA011.1OcCXTY
<br />ewlMsnueE X oOcuR EPK114155 mwncE�a aErrrEo 50,0110
<br />X X 09722/2056 09/22/2018
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<br />Transporation Poll. ' .P-IEP.ESP_tnn ore ran 10,0 0
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<br />PE SONAL AAgy LNJUR'f 91000,000
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<br />GENT AGOR PATE LIMITAPIP`1-6 PERI RA /O(iR=OATE�„_ g 4,000,000
<br />I POUOYI hµ1 jECY I�I L00
<br />X Contraccma Pollution Liability LP39PQa—TS�Og.LwtpPA0D_ A 4A00,000
<br />Or HER ' �Deductible s 2,600
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<br />AUTOMODUCLIAMUTY
<br />X ANY AUTO
<br />oNINEA I SCITCPULEU
<br />I AIUIgqT��OS ONLY AUTOS CC
<br />X X hpTO�aOML�
<br />X
<br />X
<br />721.1UNP'1*4318
<br />12t17l2016I
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<br />51809'080
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<br />(08722l201SI
<br />CEO X RETENTIONS -1010881
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<br />DESCRIPTOR n OF OPERATIaNS ild ransprtaOCATIONS I VEf11Goll lunar wittanPon aamn,itssMad a, maybe Wethad Salle
<br />`P Pollution aro a Claims Made basis. When required by written contract, the General Liability antl Pot lotion
<br />Li ability mid TmoleCt
<br />blIfty Lim It tams orthe ni
<br />Liability Limits are on a Per Proleat basis while dedicated; the Prafasstonot Liability is on a Por Policy basin.
<br />The City of Santa Ana and Community Development Agency, 20 Civic Center Plan, M'26 Santa Ana, CA 92702, thair officers, are ploy sea, agents and
<br />voiunroom are Incl udod as additional Insureds for Can aml Liability and Auto Lfarelity with Al%pact to work pononned for them by the Named Insured as
<br />Tamil red by written contract, per Blanket Additional Insured can Dream ant CG20100704, CO20370704 & HA99160311, Llebilily Coverage Is Prim sty and Non-
<br />Contnbutoryasrequlredbywrittencontract, per endorsement CFENV 010361013&HA9910312. Blanket Waivarof Subeogatlonapplioslo General Liability,
<br />SEEATTACHEDACORD101
<br />V.AFk'�CLLAI IUN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES DE. CANCELILEO aeroRE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL DE BEUVERBO IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Ste Ana AUTHORIZED REPRESENTATIVE
<br />C
<br />20 Clvlc Co�^
<br />Bantu �
<br />star Plaza. M-28
<br />ACORU 25 (2016103) 0 1 968-201 5 ACORD CORPORATION, All rights reserved.
<br />1na Awnlr name one logo are registered mark$ or ACORD
<br />
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