NV5, INC - A-2020-076-01 - Laserfiche WebLink

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dby Samantha M. Sagianth igneam Samantha M. Lambert Date: 2022 nc 12 12•31 •» ACORO® CERTIFICATE OF LIABILITY II�l�teiVCc-°'°°'"y `J DATE (MM/DD/YYYY) 5/l/2023 4/29/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies CONT NAMEACT 3280 Peachtree Road NE, Suite #250 Atlanta GA 30305 (404) 460-3600 PHONE FAX ExY : A/C No E-MAILo ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: The Continental Insurance Company 35289 INSURED NV5 Me. 1491108 163 Technology Drive INSURER B: National Fire Insurance Co of Hartford 20478 INSURER C : Transportation Insurance Company 20494 INSURER D : National Fire and Marine Insurance Co 20079 Suite 100 Irvine CA 92618 INSURER E INSURER F : COVERAGES Irvine CERTIFICATE NUMBER: 17540928 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE XOCCUR Contractual Liab Y N 7014856125 5/1/2022 5/1/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE PREM SESOEa oNcurrDence $ 1,000,000 X MED EXP (Any one person) $ 15,000 X Cross Liab lncl PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n PRO - POLICY F-1 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y N 7014842659 5/1/2022 5/1/2023 COEaMBINED ident SINGLE LIMIT acc $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $ XXXXXXX PROPERTY DAMAGE Per accident $ XrXXXXXX $ XXXXXXX A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 7014841883 5/1/2022 5/1/2023 EACH OCCURRENCE $ 20,000,000 AGGREGATE $ 20,000,000 DED X RETENTION $ $0 $ XXXXXXX B C AND EMPLOYERS' LIABILITY WORKERS COMPENSATION ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? FNI (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N 7014842824 AOS 7014842810(CA) 5/1/2022 5/1/2022 5/1/2023 5/1/2023 X STATUTE EERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D A A Prof/Poll Liab Bus Per Prop Leased/Rented Equip N N 42-EPP-321328-01 7014856125 7014900785 5/1/2022 5/1/2022 5/1/2022 5/1/2023 5/1/2023 5/1/2023 Ea. Claim/Agg. $10M/$20M Limit$18,016,286 Limit $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 17540928 City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED THE EXPIRATION DATE THEREOF, N ACCORDANCE WITH THE POLICY PROVISI AUTHORIZED a 1tWeM wmtDMsEmt <" �� REVIEWED&APPROVED By., 13hKManagement$upervrsor ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD TION. All riahts reserved.