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Digitally signed by Francine R.
<br />Francine R. Villareal Villareal
<br />A� o® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DDIYYYY)
<br />E(MMI DIY
<br />021
<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 />Dealey, Renton & Associates
<br />790 E Colorado Blvd #460
<br />Pasadena CA 91101
<br />CONTACT
<br />Marie Swaney
<br />PHONE FAX
<br />AIC No Ext : A/C, No):
<br />ADDRESS: mswaney@dealeyrenton.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Travelers Property Casualty Company of America
<br />25674
<br />License#: 0020739
<br />INSURED PROJPAR-01
<br />Project Partners
<br />949 852-9300
<br />INSURER B: The Travelers Indemnity Company of Connecticut
<br />25682
<br />INsuRER C : US Specialty Insurance Company
<br />29599
<br />INSURER D
<br />23195 La Cadena Drive, Suite 101
<br />Laguna Hills CA 92653
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:649868523 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/YYYY
<br />POLICY EXP
<br />MM/DDIYYYY
<br />LIMITS
<br />B
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />680OJ543236
<br />4/18/2021
<br />4/18/2022
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 1,00D,000
<br />X
<br />MED EXP (Any one person)
<br />$ 10,000
<br />Contractual Liab
<br />X
<br />XCU Included
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY PRO-
<br />JECT LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />Y
<br />Y
<br />BA6R856630
<br />4/18/2021
<br />4/18/2022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,00D,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />$
<br />X NoOwnedAutos
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CUP8833Y649
<br />4/18/2021
<br />4/18/2022
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED X RETENTION $,
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />Y
<br />UB3J809976
<br />4/18/2021
<br />4/18/2022
<br />X PER OTH-
<br />STATUTE ER
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />NIA
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />C
<br />Professional Liability
<br />USS2131833
<br />4/18/2021
<br />4/18/2022
<br />Per Claim
<br />$2,000,000
<br />Aggregate Limit
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Insured owns no company vehicles; therefore, hired/non-awned auto is the maximum coverage that applies. Blanket Wavier of Subrogation applies as required
<br />per written contract. Umbrella policy is follow -form to its underlying Policies: General Liability/Auto Liability/Employers Liability. AM Best's Rating for all policies
<br />listed are: A/XII or greater.
<br />Re: Agreements: A-2018-213, A-2019-117-01, A-2020-153-04 --
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insured as respects general and auto liability as
<br />required per written contract or agreement. General Liability is Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of
<br />subrogation per the attached endorsement(s).
<br />CERTIFICATE HOLDER CANCELLATION 30 Day Notice will be sent to holder
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF,
<br />NOTICE WILL
<br />BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th Floor
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702
<br />,.orta
<br />Risk ManagementDiviaitm
<br />& APPROVED BY:@
<br />1988-2015 ACORD C
<br />fiX.REVIEWED
<br />FU,y,c-," P. V
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />�_ E�'
<br />rusk Management Analyst
<br />
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