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� ® DATE ImmmorcvyY) 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 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 CONTACT NAME: Hi$DD%IOC. PHONE E 978.344.4200 AIC No: E-MAILADDRESS: contactus@insurancebee.com 520 Madison Avenue, 32nd Floor INSURERS AFFORDING COVERAGE NAICC New York, NY 10022 INSURER A: Hiscox Insurance Company Inc. 10200 INSURED CEM Construction INSURER B INSURER C : INSURERD: 1412 Espanol Ave Montebello CA INSURER E: INSURER F: 90640 COVERAGES CERTIFICATE NUMBER: 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 LTR rypE OF INSURANCE A D MID POLICY NUMBER POLICY EFF MMIDOMW POLICY EXP MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE 1:1OCCUR DA G TO ENT PREMISES Es occurrence $ MEO EXP (Any one person) $ PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PH0LOG PRODUCTS-COMPIOPAGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Par person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accitlent $ NON -OWNED HIRED AUTOS AUTOS UMBRELLALMB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LUIB CLAIMS -MADE DID RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YINANY STATUTE ER ECUTIVE E.L. EACH ACCIDENT $ OFFICERIMEMBEREEXCLUDED ❑ NIA E.L. DISEASETEM PLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMn $ A Professional Liability Y N 34562615-PL 09/15/202109/15/2022 Each Claim: $1,000,000 Aggregate: $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect toGeneral and Auto Liability per th attachedendorsements as required by written contract. Insurance is Primary and Non-Contributory.30 Days Notice of Cancellation with 10 Days Notice forNon-Payment in accordance with the policyprovisions.16-6862 Cabrillo Park Drive Sidewalk Improvements CERTIFICATE HOLDER CANCELLATION City of Santa Ana - Risk Management Divison, 4t Floor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD