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Digitally <br />ACOWH CERTIFICATE OF LIABILITY IN$UR <br />Ign DD/YYYY) <br />IZE <br />ii Angie AC <br />vedoo6/30/2022 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIAT O[JZHWCf�RTIFIOtR'dd�}}f��$TRR Z107r.R5 <br />CERTIFICATE AMEND, EXTEND OR ALTER TH J <br />ELY OR ANOT <br />IN <br />BE OW.THIS CERTIFICATE OF UVRANCE DOES CONSTITUTE A CONTRACT BETWEEN THE ISSUING!NSUTIVELY <br />RE Sj,AU'fH�O <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 `Brown, Craig <br />NAME: <br />INSURANCE SOURCE INC <br />4111 TELEGRAPH RD. SUITE 200 <br />vHONE (314)416-2600 pIC, No: (314)416-1011 <br />-MAIL craig@thainsurancesource.com <br />ADDRESS: <br />INSURERIS)AFFORDINDCOVERAGE <br />NAIC9 <br />ST LOUIS MO 63129-2755 <br />INSURERA: ACE Fire Underwriters Insurance Company <br />20702C <br />INSURED <br />INSURER B: ACE Property and Casualty Insurance Company <br />20699C <br />Prime Government Solutions, Inc <br />INSURERC: Chubb Indemnity Ins Co <br />12777 <br />912 S Capital of Texas Hwy <br />INSURERD; ACE Amer Ins Cc <br />22667 <br />INSURER E : <br />Austin TX 78746 <br />INSURERF: <br />COVERAGES CERTIFICATE NUMBER: CL2263023091 REVISION NUMBER' <br />THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDA13OVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO 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 />LTR <br />TYPEOFINSURANCE <br />INSD <br />Won <br />PDDCYNUMSER <br />MMIDDIVI'YY <br />MMDDYIYVVV <br />LIMITS <br />X <br />COMMERCML GENERAL UABILITY <br />DWM$-MADE �X OCCUft <br />EACH OCCURRENCE <br />$ 1,000,000 <br />PREMISES Ea occurrence <br />$ 1,000,000 <br />MEDEXP(Anroneporson) <br />$ 5,000 <br />PERSONAL&ADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />Y <br />TECTXD948112721X <br />06115/2022 <br />05/15/2023 <br />LIMITAPPUES PER: <br />LOCPRO <br />POLICY JECTEJ <br />GENERALAGGREGATE <br />$ 2,000.000 <br />GENLAGGREGATE <br />PRODUCTS-COMP/DPAGG <br />$ 2,000,000 <br />Employee Benefits <br />$ 100.000 <br />OTHERS <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea ac &nl <br />$ 1,000,000 <br />BODILY INJURY(Per person) <br />S <br />ANY ALTO <br />A <br />OWNED ScHEDULED <br />AUTOS ONLY AUTOS <br />y <br />y <br />TECTXD948112721X <br />05115/2022 <br />D5115f2023 <br />BODILY INJURY (Per ecdden0 <br />S <br />X <br />HIRED v NON -OWNED <br />AUTOS ONLY /� AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accidem <br />$ <br />S <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 2.000,000 <br />B <br />EXCESS UAB <br />CLAIMS -MADE <br />Y <br />Y <br />UMBTX0948111323N <br />D5/15/2022 <br />05/1512023 <br />AGGREGATE <br />s 2.000,000 <br />DEO I I RETENTION S 0 <br />$ <br />G <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LIABILITY Y <br />ANY PROPRIETOMMUNER/EXECUTIVE ❑ <br />OFFICER/MEMBER EXCLUDED? <br />IMandilaryln NH) <br />IIVee, dW=W under <br />DESCRIPTION OF OPERATIONS Mi. <br />NIA <br />Y <br />71778180 <br />05/15/2022 <br />OSMS/2029 <br />PER OTH- <br />X STATUTE ER <br />E.L. EACHACCIDEW <br />$ 1'000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />S 1,000,000 <br />EL DISEASE -POLICY LIMIT <br />S 1-000,000 <br />D <br />Professional and Cyber Liability <br />D94366458 <br />09/01/2021 <br />05/14/2023 <br />$5,000.000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORO 101, Atltlalonal Remmka Sopetlule, may be attached if more space V regnlratl) <br />The City of Santa Ana, its officers, officials and volunteers are to Covered as additional isnureds on the CGL policy with respect to liability arising out of Work <br />or operations performed by or on behalf of the contractor including materials, parts or equipment furnished in connection With such work off operations. This <br />coverage is primary and non-contributory at lease as broad as ISO CG 20 10 1185 as respects the Entity, it's officers officials, employees or volunteers. <br />Any insumace, of self insurnace maintained by the Entity, it's officers, wmployees or volunteers shall be excess of the Contractors insurance and shall not <br />contribute with H. The CGL policy and workers compensation policies oft the Entity a waiver of subrogation, <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana <br />ACORD 25 (2016103) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDA,WE WITH THE POLICY PROVISIONS. <br />CA 92702 <br />©1988-2015 <br />The ACORD name and logo are reg' eyed marks of ACORD <br />REVIEWED & APPROVED BY: <br />A141 Acardd <br />Risk Management Spedalisl <br />