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pigitally signed by Francine R. <br />Francine R. Villareal Villareal <br />ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDDIYYYY) <br />9/1/2021 <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 />AssureclPartners Design Professionals Insurance Services, LLC <br />3697 Mt. Diablo Blvd Suite 230 <br />Lafayette CA 94549 <br />Y <br />CONTACT <br />NAME: Karin Thorpe <br />PHONE 714�27-6810 FAX <br />ac Na: <br />EMAIL <br />ADDRESS: Desi nProCerts AssuredPartners.com <br />INSURERS AFFORDING COVERAGE <br />NAIC If <br />INSURERA: LIBERTY INSURANCE UNDERWRITERS INC <br />19917 <br />License#: 6003745 <br />INSURED <br />WARE MALCOMB <br />INSURER B: Continental Casualty COm an <br />2oaa3 <br />INSURERC: American Casualty Company of Reading, <br />20427 <br />10 Edelman <br />INSURER D: Continental Insurance Company <br />215289 <br />Irvine CA 92618 <br />INSURERS: Valle Fore Insurance Company <br />20508 <br />NSURER F : <br />1LUVt:KAUt:5 CERTIFICATE NUMBER: 1298936656 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 />FINSO <br />SUBS <br />WVD <br />POLICY NUMBER <br />POLICYEFF <br />(MMIDEVYyyyl <br />POLICYE%P <br />MM/DO <br />LIMITS <br />E <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMSMADE OCCUR <br />Y <br />Y <br />7015145376 <br />6/20/2021 <br />6/20/2022 <br />EACH OCCURRENCE <br />$1,000.000 <br />-DAMAGETO <br />PREMISESSEa occunence) <br />$1,000,000 <br />MED EXP (Any one person) <br />$15,000 <br />PERSONAL B ADV INJURY <br />$1,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY � PE� F LOC <br />GENERAL AGGREGATE <br />$2,000,000 <br />PRODUCTS-COMP/OV$. <br />00 <br />OTHER: <br />R <br />AUTOMOBILELIABILITY <br />Y <br />Y <br />7015145362 <br />6/20/2021 <br />6/20/2022 <br />COMBINED SINGLE LI00 <br />X <br />BODILY INJURY (Per p <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per a <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />X <br />PROPERTY DAMAGE <br />Per accident <br />D <br />X <br />UMBRELLALUIB <br />X <br />OCCUR <br />701545359 <br />6/20/2021 <br />6/20/2022 <br />EACH OCCURRENCE00 <br />AGGREGATE00 <br />EXCESS LIAB <br />CI -AIMS -MADE <br />DIED RETENTION$ <br />C <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETOMPARTNEWEXECUTIVE <br />OFFICERIMEMBEREXCLUDED? <br />NIA <br />V <br />7015145393 ADS <br />7015145409-CA <br />6/20/2021 <br />6/20/202. <br />6/20/2022 <br />fi/20/2022 <br />X STATUTE ER"' <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory In NH) <br />If yes, describe under <br />EL DISEASE -POLICY LIMIT <br />$1,000,100 <br />DESCRIPTION OF OPERATIONS below <br />A <br />Professional Liability <br />Claims Made <br />AEX1964750121 <br />6/20/2021 <br />6/20/2022 <br />per claim <br />annl aggr. <br />$1,000,000 <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 />Umbrella policy is a follow -form to underlying General Liability/Auto Liability/Employers Liability <br />30 Day Notice of Cancellation applies <br />Re: Project #MSA20-0054-00, Project Name: City of Santa Ana Space Planning and Architecture. <br />City of Santa Ana are named as Additional Insured on General Liability and Auto Liability, per policy forms, with respect to the operations of the Named Insured <br />as required by written contract or agreement. Insurance coverage includes waiver of subrogation per attached. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <br />ACORD 25 (2016/03) <br />Notice of <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AU HORIZED REPRESENTATIVE <br />an on... J kalp <br />©1988-2015 AG <br />The ACORD name and logo are registered marks of ACORD <br />WdrMnugnnottD[deimr <br />ry% //REMEV/m &(APPR.�Oe�VV/EDS1� <br />8 r�+/�W.�MZ R. VLLWlrRS <br />Risk Management Analyst <br />