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AC ?/ D CERTIFICATE OF LIABILITY INSURANCE
<br />OAT
<br />03/29/2/29/2019O(
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />A
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE R(&), 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
<br />NAME Marilyn Marilyn Hagler
<br />The Juban insurance Group LLC
<br />PHONE (225 291-0405
<br />xt No• (226)291.0420
<br />C No EIlq(0
<br />4319 Bluebonnet Blvd
<br />nooRess: marilyn)@Jubaninsurance.com
<br />IINSURER(S) AFFORDING COVERAGE
<br />NAICA
<br />Baton Rouge
<br />INSURERA; Certain Und @ Lloyds of London
<br />AA-1122000
<br />LA 70809
<br />INSURED
<br />INSURER e: Travelers lnderCRY CO Of CT
<br />25682
<br />Utillworks Consulting, LLC, Ullllworks, LLC ✓
<br />INSURER C:
<br />2361 Energy Drive, Ste. 1010
<br />INSURER D:
<br />NSURER E
<br />Baton Rouge LA 70808
<br />INSURER F:
<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 OFANY 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 />ILTR
<br />TYPE OF INSURANCE
<br />INSO
<br />WV
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMm CYErF
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS MADE l
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />I OCCUR
<br />PREMISES Ea occurrence
<br />$ 250,000
<br />MED EXP(Any one person)
<br />$ 6,000
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />A
<br />PSH06720413
<br />08/06/2018
<br />08/06/2019
<br />GENLAGGREGATE
<br />X
<br />LIMIT APPLIES PER:
<br />PRO-
<br />POLICY ❑
<br />GENERALAGGREGATE
<br />$ 4,000,000
<br />-COMPIOPAGG
<br />$ 2,000,000
<br />LOG
<br />JECTPRODUCTS
<br />Employee Benefits
<br />$ 2,000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />CO. 21 EDeanSINGLE LIMIT
<br />$
<br />ANYAUTO
<br />BODILY INJURY (Par person)
<br />$
<br />A
<br />AUTOOWNES SCHEDULED
<br />AUTOS ONLY AUT05
<br />PSH05720413
<br />08106/2018
<br />08/06/2019
<br />BODILY INJURY(Peracoldenn
<br />$
<br />x
<br />HIRED v NON -OWNED
<br />AUTOS ONLY ^AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Peracddenl
<br />$
<br />Hired And Non -Owned
<br />$ 1,000,000
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />$
<br />EXCESS LOG
<br />—FTAGGREGATE
<br />CLAWS.MAOE
<br />DED RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />X
<br />AND EMPLOYERS' LIABILITY YIN
<br />STATUTE ERH
<br />E.L. EACHACCIDENT
<br />$ 1,000,000
<br />B
<br />ANY OFFICERMEMBLR EXCLUDED? ❑N
<br />NIA
<br />NIA
<br />UB-6J384926-18
<br />10/01/2018
<br />10/01/2019
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory In NH)
<br />If yes, dsscdb. under
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000-000
<br />DESCRIPTION OF OPERATIONS below
<br />Professional Liability
<br />Each & Every Claim
<br />$2,000,000
<br />A
<br />Errors & Ommisslons
<br />PSF105720413
<br />OBY06/2018
<br />08/OB/2019
<br />Aggregate
<br />$2,000,000
<br />Deductible
<br />$5,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 1D1, Additional Remarks Schedule, may be attached If more space Is required)
<br />Cyber/Technology Liability $2,000,000 Each Claim $2,000,000 Aggregate,
<br />Applicable to Certificate Holder: Blanket Additional Insured, Primary Non -Contributory basis, 30 days notice Of cancellation (10 days for non-payment) and
<br />Wavier of Subrogation Included in the General Liability Genera) Condition wording, If required by written contract. has of Sggo Rai In j�g�,�j7pr of
<br />certifcete holder when required by written agreement with respects to Workers Compensation. � q t
<br />R i ya
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana, The City, Its offcars,amployees agents, volunteers &
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />representatives as addl Insds
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />J
<br />J
<br />W 1Una-ZVIO AGURU CUHPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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