DOMINGUEZ GENERAL ENGINEERING, INC.

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p ��`� CERTIFICATE OF LIABILITY INSURANCE FD121161210yYYY) 12/16/2024 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. 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 6013466 1-562-270-0787 CONTACT NAME: Jose L. Gurrola Bear Risk Management, Inc. PHONE 562-270-0787 FAX A/C No Ext: A/C,No): dba JL Gurrola Insurance Agency E-MAIL ia.com9 certificatesnow@'1 ADDRESS: certificatesnow@jlgia.com 100 W. Broadway Suite 3000 INSURER(S)AFFORDING COVERAGE NAIC# Long Beach CA 90802 USA INSURERA: Scottsdale Insurance Company 41297 INSURED INSURERB: United Financial Casualty Company 11770 Dominguez General Engineering, Inc. Everest Premier Insurance Company 16045 INSURERC: P Y dba Dominguez General Engineering Contractor INSURERD: Evanston Insurance Company 35378 11096 Pipeline Ave. INSURER E: Travelers Property Casualty 25674 Pomona CA 91766 USA INSURERF: COVERAGES CERTIFICATE NUMBER: 1216-06-GA REVISION NUMBER: 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 BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD X COMMERCIAL GENERAL LIABILITY X X BCS2002162 12/15/24 12/15/25 EACH OCCURRENCE $ 11000,000 CLAIMS-MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 A X Deductible: $ 5,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 100,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY� PEA LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY X X COMBI975624551 12/15/24 06/15/25 Ee a.identED SINGLE LIMIT $ 11000,000 ANY AUTO BODILY INJURY(Per person) $ B X OWNED X SCHEDULED BODILY INJURY(Per accident) AUTOS ONLY AUTOS $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY Per accident $ S UMBRELLA LAB X OCCUR XLS2005843 12/15/24 12/15/25 EACH OCCURRENCE $ 4,000,000 A X EXCESS LAB CLAIMS-MADE AGGREGATE $ 4,000,000 DED RETENTION$ N/A $ WORKERS COMPENSATION X X AND EMPLOYERS'LIABILITY YIN 7600024851241 10/01/24 10/01/25 1 STATUTE ER C ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Contractors Pollution Lia. X X CPLMOL124441 06/10/24 06/10/25 Ea Occ & Agg Limit $ 2,000,000 E Property/Inaland Marine X X 660 3X218203 10/01/24 10/01/25 Installation Limit $ 700,000 E Property/Inaland Marine X X 660 3X218203 10/01/24 10/01/25 Lsd/Rntd Equipment $ 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Re: Project No. 21-6453 NE Annexation Water & Sewer Maint Improvements The City of Santa Ana, its officers, officials, employees and volunteers are additional insured per attached endorsement(s). Coverage is primary and non-contributory per policy wording and attached endorsement(s). Waiver of Subrogation applies per attached endorsement(s). Excess Liability is follow form. APPROVED By Tu Tran Nguyen at 12:01 pm,Jan 30,2025 30 Day Notice of Cancellation/ 10 Day for Non-Payment. CERTIFICATE HOLDER CANCELLATION The City of Santa Ana Risk Management Division 4th Floor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 USA red Tu Tran byu Nguy Tran yen ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Nguyen°ate: BEARRISK06 12 02 1.-0: :zi a'oo' 1216-06-GA