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r2bbly Vgncl by Fandnea
<br />Francine R. Villareal vm.,Nl
<br />A— W20,10.14 n:xe 33 LTdy
<br />ACORO® CERTIFICATE OF LIABILITY INSURANCE
<br />I`/
<br />DATE(MMIDDmyY)
<br />09/15/2020
<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(fes) 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 />CONTACT Tina Cowie
<br />NAME:
<br />Cornerstone Specially Insurance Services, Inc.
<br />PHONE (714) 731-7700 FAX (714) 731-7750
<br />A/C No Ex : A/C, No):
<br />14252 Culver Drive, A299
<br />E-MAIL tina@comemtonespecialty.com
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICa
<br />INSURERA: Continental Casualty Company
<br />20443
<br />Irvine CA 92604
<br />INSURED
<br />INSURERS: American Cas.Co. of Reading PA
<br />20427
<br />PROACTIVE CONSULTING GROUP, LLC
<br />INSURER C :
<br />15235 Springdale St.
<br />INSURER D:
<br />NSURER E
<br />Huntington Beach CA 92649
<br />INBURER F
<br />COVERAGES CERTIFICATE NUMBER: 2020/2021 COVERAGES REVISION NIIMRFR-
<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 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MMmO/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE FX1 OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />PREMISES Ea otturtence
<br />$ 300,000
<br />X
<br />MED EXP(Any mm person
<br />$ 10,000
<br />ADDT'L INSURED I P & NC
<br />X
<br />BLNKTWVROFSUBRO
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />A
<br />Y
<br />Y
<br />2084330890
<br />06/01/2020
<br />06/01/2021
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />POLICY X PROJECT LOG
<br />GENERALAGGREGATE
<br />$ 4,000,000
<br />PRODUCTS - COMPIOP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />Y
<br />Y
<br />2084330890
<br />06/01/2020
<br />06/01/2021
<br />BODILY INJURY (Per accident)
<br />$
<br />XHIRED
<br />NON -OWNED
<br />AUTOS ONLY IX AUTOSONLY
<br />PROPERTY DAMAGE
<br />fPer accident
<br />$
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEC
<br />I I RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITYYIN
<br />ANY PROPRIETOR/PARTNER/EXECUTWE fl
<br />OFFICERIMEMBER EXCLUDED'/
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />Y
<br />4024152345
<br />06/01/2020
<br />06101/202,
<br />PER OTH-
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 11000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Professional Liability
<br />Claims Made
<br />EEH288355962
<br />07/28/2020
<br />07128/2021
<br />Each Claim
<br />AnnualA re
<br />Aggregate
<br />9
<br />$1,000,000
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required)
<br />RE: Environmental Compliance Consulting Services
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Additional Insured for General &Auto Liability but only if required by
<br />written contract with the Named Insured prior to an occurrence and as per attached endorsement. Such insurance as is afforded by this policy shall be
<br />primary, and any insurance carried by City shall be excess and noncontributory. Coverage is subject to all policy terms and conditions. *30 days notice of
<br />cancellation, except for 10 days notice for non-payment of premium. For Professional Liability coverage, the aggregate limit is the total insurance available
<br />for all covered claims reported within the policy period.
<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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Mgmt. Division, 4th Floor
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702 Risk Man%mcad Dhidan
<br />RENE\VEO & APPROVED Sr
<br />01988-2015 ACORD I i!AIW:
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD -�—' Risk Management Analyst
<br />
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