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RINCCON-n1 <br />PHII 1 IPCr` <br />o CERTIFICATE OF LIABILITY INSURANCE <br />n`. <br />DATY) <br />2/1/2 <br />211/201188 <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER License#OE67768 <br />NQINTEACT Elizabeth Leach <br />Legends Environmental Ins. Services <br />130 Vantis <br />Suite 250 <br />Allso Viejo, CA 92656 <br />PHONE FAX <br />AIc, IN Eau): (949) 297-5537 52011 (Alc, N.):(949) 297-5960 <br />AEb%A,'L5ss, Elizabeth. Leach@ioausa.com <br />INSURER B AFFORDING COVERAGE NAIC p <br />INSURER A: Crum ✓£ Forster Specialty Insurance Company 44520 <br />X <br />INSURED <br />INSURER B: Trumbull Insurance Company 27120 <br />INSURER C:StarStone National Insurance Company 25496 <br />Rincon Consultants, Inc. b/ <br />INSURER D <br />210 N Ashwood Ave <br />Ventura, CA 93033 <br />DAMAGE TO RENTED <br />occurrsn <br />50,000 <br />NSURER E <br />NSURERE: <br />$ 10,000 <br />COVFRAr;FS CFRTIFICATF NIIMRFR- oP%/IQInNI NII Il,RRCG. <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 MAYBE 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 />LT <br />TYPE OF INSURANCE <br />ADDLSuss <br />❑ <br />D <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />A <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCUR <br />Transportation Poll. <br />X <br />X <br />EPKI14155 <br />09122/2016 <br />09/22/2018 <br />EACH OCCURRENCE <br />- <br />$ 3,000,000 <br />DAMAGE TO RENTED <br />occurrsn <br />50,000 <br />X <br />MED EXP (Any one erson <br />$ 10,000 <br />PERSONAL &ADV INJURY <br />$ 3,000,000 <br />LIMIT APPLIES PER: <br />POLICY ® JE� El LOC <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GEN'LAGGREGATE <br />PRODUCTS-COMP/OPAGG <br />4,000,000 <br />X <br />OTHER: Contractors Pollution Liability <br />Deductible <br />2,500 <br />B <br />AUTOMOBILE <br />LIABILITY <br />COMBINEDSINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY Per erson <br />$ <br />X <br />ANY AUTO <br />AAUTOS ONLY SCHEDULED <br />X <br />X <br />72UUNPT4318 <br />12/17/2017 <br />12117/2018 <br />w.- <br />BODILY INJURY Per accident <br />$ <br />X <br />X <br />AIIRTOS ONLY X NO -OS ONLY <br />Pion oil Oetl <br />S$MBRELLA <br />PerOaaolRdnt AMAGE <br />A <br />LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 5,000,000 <br />X <br />EXCESS LIAB <br />CLAIMS -MADE <br />EFX108624 <br />09/2212017 <br />09/22/2018 <br />AGGREGATE <br />$ 5,000,000 <br />DEO 7X I RETENTION$ 10,000--- <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />AApNNpY PROPRIETOR/PARTNER/EXECUTIVE <br />(MandER/MatoryEM NER EXCLUDED? � <br />If yes, describe under <br />-DESCRIPTION OF OPERATIONS below <br />NIA <br />X <br />710180329 <br />02/01/2018 <br />02/01/2019 <br />_- <br />�( PER OTH- <br />ER <br />E. L. EACH ACCIDENT <br />$ 11000,000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />1,000,000 <br />A <br />Professional Llab.* <br />EPK114155 <br />09/22/2016 <br />09/22/2018 <br />Per Claim <br />3,000,000 <br />A <br />Professional Liab.* <br />EPKI14155 <br />09122/2016 <br />09/2212018 <br />Aggregate <br />4,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD iDi, Additlonal Remarks Schedule, maybe attached If more space Is required) <br />*Professional Liability and Transportation Pollution Liability are written on a Claims Made basis. When required by written contract, the General Liability and <br />Pollution Liability Limits are on a Per Project basis while dedicated; the Professional Liability is on a Per Policy basis. Professional Liabilty Deductible $10,000 <br />Each Claim. <br />The City of Santa Ana and Community Development Agency, 20 Civic Center Plaza, M-26 Santa Ana, CA 92702, their officers, employees, agents and <br />volunteers are included as additional insureds for General Liability and Auto Liability with respect to work performed for them by the Named Insured as <br />required by written contract, per Blanket Additional Insured endorsement EN0147.1111, EN0320-0211, EN0321-0211 & HA99160312. Liability Coverage is <br />SEE ATTACHED ACORD 101 <br />4;CIty� of Santa Ana <br />20 Civic Center Plaza, M-26 <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 />REPRESENTATIVE <br />ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />