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<br />AC40R �' CERTIFICATE OF LIABILITY INSURANCE Jacobs o2050,.
<br />.
<br />04
<br />DATE(MM//2022Y)
<br />08/03/2022
<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
<br />Willis Towers Watson Insurance Services West, Inc.
<br />c/o 26 Century Blvd
<br />P.O. Box 305191
<br />CONTACT Willis Towers Watson Certificate Center
<br />NAME:
<br />PHONE 1-877-945-7378 FAX 1-888-467-2378
<br />A/C No Ext : A/C , No :
<br />E-MAIL
<br />ADDRESS: certificates@willis.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />Nashville, TN 372305191 USA
<br />INSURERA: National Fire Insurance Company of Hartfor
<br />20478
<br />INSURED
<br />IEC Corporation
<br />16485 Laguna Canyon Rd #300
<br />INSURERB: Valley Forge Insurance Company
<br />20508
<br />INSURERC: Continental Insurance Company
<br />35289
<br />INSURERD: Hartford Fire Insurance Company
<br />19682
<br />Irvine, CA 92618
<br />INSURERE: Lloyds Syndicate 2987
<br />C0978
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: W25600572 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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />x
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE � OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 15,000
<br />A
<br />Y
<br />7015251780
<br />07/31/2022
<br />07/31/2023
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />POLICY D PRO-
<br />JECT LOC
<br />PRODUCTS - COMP/OPAGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />x
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />Y
<br />7015271690
<br />07/31/2022
<br />07/31/2023
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />C
<br />x
<br />UMBRELLALIAB
<br />x
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 15,000,000
<br />AGGREGATE
<br />$ 15,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />7015251746
<br />07/31/2022
<br />07/31/2023
<br />DED RETENTION $
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICE R/M EMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N/A
<br />59 WE AL3MXU
<br />06/01/2022
<br />06/01/2023
<br />x PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />E
<br />Student Professional
<br />MPL3031022
<br />07/31/2022
<br />07/31/2023
<br />Per Claim
<br />$2,000,000
<br />Liability
<br />Per Aggregate
<br />$4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />This Voids and Replaces Previously Issued Certificate Dated 08/02/2022 WITH ID: W25590565.
<br />The City of Santa Ana and its officers, employees, agents, volunteers, and representatives are included as Additional
<br />Insureds as respects to General Liability and Auto Liability if required by written contract.
<br />General Liability and Auto Liability policies shall be Primary and Non-contributory with any other insurance in force
<br />CERTIFICATE HOLDER CANCELLATION
<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 />City of Santa Ana
<br />Risk Management Division
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Ride
<br />Santa Ana, CA 92702
<br />—
<br />© 1988-2016 ACORD C(\
<br />REviDveO&APPROVED Br
<br />ACORD 25 (2016103)
<br />The ACORD name and logo are registered marks of ACORD
<br />- -_
<br />Risk Management Analyst
<br />SR ID: 22913564 BATCH: 2619772
<br />
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