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Francine R. Ulyllallyfliined by Forclne N. Villareal Villareal leaozl.w.znzea:n e?W BIGBENC-01 CTYLER CERTIFICATE OF LIABILITY INSURANCE I DATE^MMallf^O^wYV) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(&), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policyl must have ADDITIONAL INSURED provisions or be endoreed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement s). PRODUCER Liters e # OM7O471 cgNLAcr Ciera Tvler INSURED Insurance Services, An Alem Group Insurance PHONE - WC. No. Eau: (949) 942.1100 Big Ben, Inc. 4790 Irvine Blvd. #105.404 Irvine, CA 92620 COVERAGES CFRTIFICATF NUMBER: eomna,nn u, u.e.,-e.. --- "� ••�"• ,\ V 1YILaGR. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE REDUCED BY PAID CLAIMS, .. _......_. _. ___.__--- _ -___. ..._____....__. INSR TYPE OF INSURANCE ADOL SU6B POLICY NUMBER POLICY EFF POLICY EXP_I. LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE, 1,000,000 _-,CLAIMS-MADE LXI OCCUR .. X X 100008889B201 4I512021 4/6/2022 ___ DAMAGE TO RENTED PREMISES LEfl.osonrf@atMJ___ - 900,006 $....... ____......_--------- __ .- WED EX_P.( ny oneperson).._-, $... 5,000 .._..._.. PERSONAL&ADV INJURY R_ 1000,000 _GEN'L AGGREGATE LIMIT APPLIES PER: qo 141 L . GENERALAGGREGATE __ $_ 21000,000 POLICY JECT ...... LOG PROOUCTS_COMP/OP AGO_, ,$,_ ...._ 21000r000 THER: $ AUTOMOBILE ._ _. LIABILITY COMBINED SINGLE LIMIT $ . _.__._.......__ ANY AUTO OWNED SCHEDl1LED--- AUTOSONLY BQDILYINJUR,Y.F rpmaonl 8_ -- ___ AUTOS pQDILY INJURY Teracntlen0..,,$_ -. qgEE VWVNN Dp P�T090NLY AU01N'060NLV qq pp .- .......____._ _. __. _LPe�eccltlenp_AMAGE .$_____....... —__.._..._--- _._ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE 4,Oo0,000 X EXCESS LAB CLAIMS -MADE- 1000337276201 4/612021 4/61022 _. AGGREGATE 4000r000 N$ LIED RETENTIO WORKERS COMPENSATION PER OTH AND AND EMPLOYERS' LIABILITY YIN I S'CALUTE_ FR __... ._,__._. ._....... ANYICROMIETOREACLUDEE4ECUTIVE I �JFFR) r NIA ELEACH AC -CI 0,ENT § ands oryPin -- Ifyyes, describe mdeY E L DISEASE _EA EMPLOYE_._ .$._ .-_.._. .._.... OESNIPTIONCF OPERATIONS below EL. DISEASE -POLICY LIMIT $ Additional Remarks Schedule, maybe attached if more space Is required) DESCRIPTION OF21.644ATIONSILOCATIONo VEHICLESACORDUpgrade RE: Project #21.6446 Baker -Glenwood Sewer Main Upgrede City of Santa Ana, Its officers, employees, agents and representatives are Additional Insureds with respect is named as additional Insured when required by written contract per the attached General Liability endorsement. Primary and non-contributory coverage applies when required by written contract perthe attached General Liability endorsement. Waiver of subrogation applies when required by written contract per the attached General Liability endorsement. SEE ATTACHED ACORD 101 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS, 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE �. klekMwt�lnm4R(vislpn REAEWED.&APPROVED BY:_ ACORD 25 (2016/03) ©1988-2015 ACORD CO >« The ACORD name and logo are registered marks of ACORD 2nk ManageRremAnalyst