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74/30/2025
<br /> (MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE
<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 /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME: Suzanne B.POsada
<br /> IAG Insurance Services PHONE FAX
<br /> 111 Corporate Drive, Suite 100 A/C No EXt: 949-396-1015 vc,No):949-387-2324
<br /> Ladera Ranch CA 92694 ADDRESS: sbp@iagins.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#: OD78344 INSURERA:American Casualty Company of Reading, 20427
<br /> INSURED CLINLAB-01 INSURER B: Continental Casualty Company 20443
<br /> Clinical Laboratory of San Bernardino
<br /> Geo-Monitor, Inc. INSURERC: Oak River Insurance Co. 34630
<br /> 21881 Barton Road INSURERD:Transportation Insurance Company 20494
<br /> Grand Terrace CA 92313 INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:887937365 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 CONTRACT OR 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 6072997663 2/1/2025 2/1/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea or
<br /> $100,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY PRO LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> X JECT
<br /> OTHER:El $
<br /> D AUTOMOBILE LIABILITY Y Y 7036574348 2/1/2025 2/1/2026 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> B X UMBRELLALIAB X OCCUR CUE6076281162 2/1/2025 2/1/2026 EACH OCCURRENCE $5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED X RETENTION$in ono $
<br /> C WORKERS COMPENSATION Y CLWC666456 2/1/2025 2/1/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Environmental Prof Liability Y EEH276170923 2/1/2025 2/1/2026 Per Claim $4,000,000
<br /> Claims Made Aggregate $4,000,000
<br /> Deductible $100,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:All Operations usual to the insured's operations are subject to the policy terms and conditions.
<br /> City of Santa Ana,its officers,officials,employees,and volunteers are included as Additional Insureds to the General Liability. Coverage is Primary&
<br /> Non-Contributory,and a Waiver of Subrogation applies.
<br /> Blanket Auto Liability Additional Insured is included as required by written contract.Waiver of Subrogation applies with respect to Auto Liability.
<br /> Blanket Waiver of Subrogation for Workers'Compensation shall apply as required by written contract per the attached endorsement.
<br /> See Attached...
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Tran Nguyen of 7:16 am,May 01,2025
<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 Dg1,11y,i,�Ed ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn: Public Works Agency Tu Train by To Tran
<br /> Robert Hernandez ogtY.
<br /> Nguyen Dd1eZozs.os.o� AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza 07d7 12- °
<br /> Santa Ana CA 92701 R 1a K.Le
<br /> U @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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