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OCEABLU-06 EYOUS
<br />.d►`oRv CERTIFICATE OF LIABILITY INSURANCE oA RMB12f120
<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 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 />PRODUCER Llcenil 0757775
<br />CONTACT Andrew Shutak
<br />San Diego, CA - Mira Sorrento - HUB International Insurance Services Inc.
<br />PHONE
<br />Eet)_ (858) 373.6953 FAX No).
<br />9855 Scranton Road
<br />Suite 100
<br />-INC.
<br />PdtNjss. andrew.shutak@hubinternational.com
<br />San Diego, CA 92121
<br />-_ --- —_._ _.—...
<br />-- --
<br />INSURERIS) AFFORDING COVERAGE
<br />NAIL 9
<br />INSURER A. Greenwich Insurance Company,. _.
<br />22322 _
<br />INSURED
<br />INSURERB:XL Specialty Insurance Company
<br />37885__
<br />Ocean Blue Environmental Services, Inc.
<br />_INSURER C. Indian Harbor Insurance. Company
<br />36940
<br />925 West Esther Sheet
<br />INSURER D
<br />Long Beach, CA 90813
<br />--
<br />INSURER E
<br />I
<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
<br />WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN IS SUBJECT TO ALL
<br />THE TERMS.
<br />EXCLUSIONS_ AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN EDUCED BY PAID CLAIMS__
<br />_R_
<br />INSR TYPE OF INSURANCE AODL SUER pOUCY NUMBER POLICY EFF POLICY E%P
<br />LTR
<br />LIMITS
<br />A X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE S
<br />—__.._._ - -
<br />1,000.000
<br />CLAIMS -MADE X OCCUR X GEC3001568 711l2020 ^T't#f,�24
<br />--
<br />PAMAGETO RENreo
<br />REMIBE�.(Ea_95wev±cei _ 1
<br />100,000
<br />_.
<br />MED EXP (Any PAa parse 1 j_
<br />5,000
<br />PERSONAL B ADV INJURY 5
<br />1,000,000
<br />G ENL AGGREGATE LIMIT APPLIES PER
<br />GENERALAGGREGATES_
<br />2,000,000
<br />X POLICY I J JELQT LOC
<br />. PRODUCTS COMP'OP AGO }_
<br />2,000,000
<br />X OTHER. DIED: $5,000
<br />_
<br />B AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT S
<br />1,000,000
<br />X ANY AUTO _ _ AECO056991 711/2020 71112021
<br />BODILY INJURY (Per persons
<br />OWNED SCHEDULED
<br />.3
<br />AUTOS ONLY _ AUTOS
<br />BODILY INJURY,Par arc da=l 5
<br />y�
<br />X AUTO X AUTOSO E'?
<br />PPP Ora RTY DAAAGE
<br />. ONLY
<br />X MCS-90 Poruttw
<br />;
<br />Hazardous Waste -
<br />5,000,000
<br />C - X UMBRELLA LAB X OCCUR
<br />EACH OCCURRENCE 3
<br />9,000,000
<br />EXCESS LIAB CLAIMS -MADE UECO056992 711/2020 71112021
<br />9,000,600
<br />AGGREGATE
<br />DED X RETENTIONS 10,066
<br />__$
<br />B WORKERS COMPENSATION
<br />X PER Or" -
<br />AND EMPLOYERS'LIABILITY YIN
<br />-STATUTE _ER
<br />_
<br />ANY PFOPRIETORIPARTNEREXECUTIVE WEC3001567 711/2020 711I2021
<br />EL EACH ACCIDENT j
<br />1,000,000
<br />D)FFICcEfL'MEMgER E%CLUOEDP NIA'
<br />(Mantlalary In NH)
<br />EL DISEASE - EA EMPLOYEES
<br />1,000,000
<br />Use Pail under
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS polo.
<br />EL DISEASE -POLICY LIMIT S
<br />C Pollution PECO057033 711/2020 7/1/2021
<br />Each OcclAggregate
<br />5,000,000
<br />C Professional LTab. PECO057033 71112020 71112021
<br />Each Occ/Aggregate
<br />5,000,000
<br />DESCRIPTION OF OPERATIONS, LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedulemay tre attached If more space Is required)
<br />RE: RFP# 16-144
<br />With respects to General Liability: City of Santa Ana, officers, agents, employees, and volunteers are named as additionally Insured an this policy pursuant to
<br />written contract agreement, or memorandum of understanding. Such Insurance as is afforded by this policy shall
<br />be primary, and any Insurance
<br />carried by
<br />City shall be excess and noncontributory.
<br />REVIEWED & APPROVED
<br />By Risk MANAGEMENT DIVISION
<br />CERTIFICATE HOLDER A_ 1 U LL _'—U 711711. reurPI I ATInN
<br />City of Santa Ana FI A E (' I AL
<br />Risk Management Division
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE ACCORDANCE LION DATETICE WILL BE DELIVERED IN
<br />THE POLICYPROVISIONS.THEREOF,
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />4V41( r+erL_
<br />Santa Ana, CA 92702
<br />ACORD 25 (2016/03) P 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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