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Client#: 835015
<br />ALTAPLAN
<br />ACORDIM CERTIFICATE OF LIABILITY INSURANCE
<br />FEATE(MM/DD/YYYY)
<br />12/20/2017
<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 />CONTACT Lori Andrews
<br />USI Northwest CL1
<br />_
<br />PHONE FAX
<br />A/C, No, Ext : 503 299-4346 ,e,/c, No), 610 362-8130
<br />700 NE Multnomah, Suite 1300
<br />ADDRESS: lori.andrews@usi.com
<br />Portland, OR 97232
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />503 224-8390
<br />INSURER A : Hartford Casualty Insurance Corni 29424
<br />INSURED
<br />INSURER B : SAIF Corporation; 36196
<br />Alta Planning + Design, Inc.
<br />- ----
<br />Hartford Fire Insurance Company 196$2
<br />711 SE Grand Avenue
<br />INSURER C :
<br />-- —
<br />INSURER D : Continental casualty company
<br />i 20443
<br />Portland, OR 97214
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MMIDD/YYYY
<br />LIMITS
<br />A
<br />X� COMMERCIALGENERAL LIABILITY
<br />52UUNHB2172
<br />9/01/2017
<br />09/01/2018
<br />EACHOCCURRENCE
<br />$1 000,000
<br />CLAIMS -MADE 4 OCCUR
<br />PREMISES ERENTED
<br />occu ence
<br />$300 000
<br />MED EXP (Any one person)
<br />$1 O 000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />�PRO-
<br />': POLICY L _' :I JECT LOC
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE LIABILITY
<br />52UUNHB2172
<br />9/01/2017
<br />09/01/2018
<br />COMB SINGLE LIMIT
<br />Ea accidentdent)
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X:I ANY AUTO
<br />ALL OWNED ! SCHEDULED
<br />_...__ AUTOS i. _ AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />. NON -OWNED
<br />X; HIRED AUTOS i X AUTOS
<br />A
<br />X!' UMBRELLA LAB X OCCUR
<br />52XHUHB1180
<br />9/01/2017
<br />09/01/2018
<br />EACH OCCURRENCE
<br />s7,000,000
<br />AGGREGATE
<br />$7 000 000
<br />EXCESS LAB CLAIMS -MADE
<br />$
<br />DED X RETENTION $10000
<br />B
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />(Mandatory inNH)
<br />NIA
<br />771940
<br />52WEAA61PB
<br />WA Stop Gap -EL
<br />9/01 /2017
<br />09/01/2017
<br />0910112018
<br />09/01/201
<br />X PER T OTH-
<br />E.L. EACH ACCIDENT
<br />-----
<br />$1 000 000
<br />E.L. DISEASE - EA EMPLOYEE
<br />-.s------
<br />$1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />OH Stop Gap -EL
<br />E.L. DISEASE -POLICY LIMIT 1
<br />$1,000.000
<br />D
<br />Professional
<br />MCH114135257
<br />09/01/2018
<br />$4,000,000 Per Claim
<br />Liability
<br />1/01/2017
<br />$4,000,000 Aggregate
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: Project #00-2017-440, Santa Ana CA Safe Routes to School Plan.
<br />The General Liability policy includes an additional insured endorsement that provides additional insured
<br />status to City of Santa Ana, its officers, employees, agents, volunteers and representatives with regard to
<br />work performed on behalf of the named insured. The General Liability policy contains a special endo sement
<br />with Primary and Noncontributory wording, when required by written contract. The General Liabil' olic
<br />provides a Waiver of Subrogation when required by written contract. REVIEWED BY: 4-11 IN EUNICE HEREDIA (PG I OF ( )
<br />City of Santa Ana
<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 />ACORD 25 (2014/01) 1 of 1
<br />#S22115874/M21455702
<br />©1988-2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />ARSZP
<br />
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