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Francine R. UanallyaynM 6y r,a�r,.. a.
<br />ymamal
<br />Villareal m,rxaxanxxanexa-aana
<br />ACOREI CERTIFICATE OF LIABILITY INSURANCE
<br />DATE IMMIDDrrYYY)
<br />Ill
<br />1 11/16/2020
<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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT Michelle
<br />NAME.
<br />CORE INSURANCE GROUP
<br />4100 International Plaza
<br />PHONE 817-471-1807 FAX
<br />AD No:
<br />E-MAIL
<br />ADDRESS: Yichelle@coreins .us
<br />Suite #150
<br />Fort Worth TX 76109
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Continental Insurance Company
<br />35289
<br />INSURED
<br />INSURERS: Valley Forge Insurance Compaxy,
<br />20508
<br />Corgan Associates, Inc.
<br />INSURER c: Continental Casualty Company
<br />20443
<br />INSURER D: Underwriters at Lloyd's
<br />401 North Houston
<br />INSURER E
<br />Dallas TX 75202
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: CLI9121326774 RFVICIOM MIINIRFR-
<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 />rypE OF INSURANCE
<br />ADDL
<br />SUER
<br />POLICYNUMBER
<br />POLICYEFF
<br />MMIDDIYYYV
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />S 2,000,000
<br />A
<br />CLAIMS -MADE ❑X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea continence
<br />S 500,000
<br />MED EXP(Any one person)
<br />$ 15,000
<br />6076463567
<br />1/1/2020
<br />1/1/2021
<br />PERSONAL aADV INJURY
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 4,000,000
<br />A
<br />POLICY � JEST rX7
<br />LOC
<br />PRODUCTS -COMPIOPAGG
<br />$ 4,000,000
<br />Per Ocomence,'Ded. ShOOD)
<br />$ 50,000
<br />X OTHER: SHORT TERM LEASED E U1pME
<br />6076463587
<br />1/1/2020
<br />1/1/2021
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />-$--,,BOB, 000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />B
<br />ANYAUTO
<br />AALL UTOS OWNED $CHESULED
<br />UTO
<br />6076417533
<br />1/1/2020
<br />1/1/2021
<br />BODILY INJURY (Per accident)
<br />$
<br />HIRED AUTOS NON-0WNED
<br />AUTOS
<br />PROPERTYDAMAGE
<br />Per accident
<br />S
<br />$
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 151000,000
<br />AGGREGATE
<br />$ 15,000,000
<br />A
<br />EXCESSIL
<br />CLAIMS -MADE
<br />DED X RETENTION S 10,000
<br />$
<br />6076417550
<br />1/1/2020
<br />1/1/2021
<br />C
<br />WORKERS COMPENSATION
<br />60764ll600-California only
<br />1/1/2020
<br />1/1/2021
<br />X PER OTH-
<br />TATUTE ER
<br />AND EMPLOYERS' LIABILITY YIN
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />ANY PROPRIETORPARTNERIEXECUTIVE =
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000 000
<br />B
<br />(Mandatory In NH)
<br />6076417564-other than m
<br />1/1/2020
<br />1/1/2023
<br />If yes, describe under
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />C
<br />CRIME
<br />596644872
<br />1/1/2020
<br />1/1/2021
<br />Per Loss ned.$60.00(i) 1,000,000
<br />D
<br />Cyber Insurance
<br />CRI65540
<br />01/01/2020
<br />1/1/2021
<br />Cyher Limit 3,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: On Call Space Planning and Architectural Services RFP No. 20-040.
<br />City of Santa Ana and all entities named S requiring additional insured status in a written executed
<br />contract with named insured are included as additional insured with respects to general liability (On a
<br />Primary S noncontributory basis for completed 6 ongoing operations) auto liability (On a primary and
<br />noncontributory basis) and Umbrella liability with a Waiver of Subrogation (WOS) in their favor. WOS
<br />applies to Workers compensation policy as well. Policies include 30 day notice of cancellation if the
<br />policy cancels for any other reason than nonpayment of premium. Above applies as long as there is a
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza,
<br />4th Floor
<br />Santa Ana, CA 92702
<br />ACORD 25 (2014101)
<br />INS025 (201401)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Jordan/MH
<br />The ACORD name and logo are registered marks of ACORD
<br />10
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