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<br />PAULUS ENG .H npF7
<br />,
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE
<br />i
<br />'l
<br />5/7/2021
<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 />Me CT
<br />THE 20 611 SW Acacia a StGE ., 200AL INSURANCE SERVICES, Inc.
<br />Newport Beach, CA 92660
<br />jaCC,,, No, Eat): (949) 287-5677 FAX
<br />(A/C, No):
<br />A'!%'NkSS-
<br />INSURER(S)AFFORDING COVERAGE
<br />NAIC N
<br />INSURER A: Executive RISK Indemnity, Inc.
<br />35181
<br />INSURED
<br />INSURER B: Federal Insurance Company
<br />20281
<br />INSURER C:
<br />Paulus Engineering, Inc.
<br />2871 E. Coronado Street
<br />Anaheim, CA 92806
<br />INSURER D:
<br />INSURER E :
<br />INSURER F :
<br />COVERAriFS rFRTIFIPATP MIIIkr4CC
<br />' V,YIp CR: 1
<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 />IILTRNSR
<br />TYPE OF INSURANCE
<br />AOOL
<br />INSDEACH
<br />SU%R
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />x
<br />54303105
<br />5/1/2021
<br />5/1/2022
<br />OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTEDPREMISES (Ea
<br />100,000
<br />MED EXP An one emon
<br />5,000
<br />PERSONAL& ADV INJURY
<br />1 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY �X JECT � LOG
<br />GENERALAGGREGATE
<br />21000,000
<br />GENT
<br />PRODUCTS-COMPIOPAGG
<br />21000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />AUTOS ONLY AUTNOSWONL�
<br />54303104
<br />5/1/2021
<br />5/1/2022
<br />EOMBINEDtSINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY Per arson
<br />$
<br />BODILY INJURY Per accident
<br />$
<br />PeOr acc Eent AMAGE
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />AGGREGATE
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />B
<br />WORKERS
<br />ND EMPLOYERS' LIABILITY YIN
<br />ANYSERIMEETORIPARTNDED? CUTIVE ❑
<br />EXCLUDED?
<br />QQppFICERry In full
<br />If
<br />Ifyes,doryin NH) escribe under
<br />OF OPERATIONS below
<br />NIA
<br />54303106
<br />5/1/621
<br />5/1/622
<br />j( PER STATUTE ETH
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />EL. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES ((ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required)
<br />RE: City of Santa Ana Agreement A-2020-215- ; Install Speed Cushions. glaip
<br />City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701, Its Officers, Employees, Agents, Volunteers & Representatives are named as Additional
<br />Insureds as respects General Liability per Attached Endorsement.
<br />This Insurance shall apply as Primary and Non -Contributory per attached endomment.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />� ri"as„� Risk ManaBement Diviel0n
<br />RENEWED & APPROVED Sr.
<br />ACORD 25 (2016103) ©1988-2015 ACORD C
<br />The ACORD name and logo are registered marks of ACORD Risk Management Analyst
<br />
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