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Angie Digitally signed by Angie Acevedo ACORO® f`CQTICIrATC nP I Wall ITV IAICI IQA(Jtevedo Date; 202 AIti; I .09.41ATE (MM DD YYYY) 09/15/2021 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 Hunter Insurance Services, Inc 9855 Prospect Ave Suite Santee CA 92071 CONTACT Miriam Rothey PHON n FAX C rt A/C No), ADDRESS: miriam@hunteronline.com INSURERS AFFORDING COVERAGE NAICN INSURERA: Westchester Fire Insurance Company 10030 INSURED CEM Construction Corp. 1412 Espanol Ave Montebello CA 90640 INSURER B: Infinity Select Insurance Company 20260 INSURER C: Capitol Indemnity Corporation 10472 INSURER D: Insurance Company of the West - ICW Group 27847 INSURER E: American Zurich Insurance Company 40142 1 INSURER F: 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. NOTWTHSTANDING 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 TR TYPE OF INSURANCE ADDLSU JNM D POLICY NUMBER MMPOLICY EFF /DD/YYYY Y Y MMI �/YYY LIMITS X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE �/ /� OCCUR DAMAGE PREMISES H occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 A Y G72539527001 8/30/2021 8/30/2022 GEN'L AGGREGATE UNIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PEDT E LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOSILELIABIUTY COMBINED SINGLE LIMIT Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 504610134744001 9/8/2021 9/8/2022 BODILY INJURY (Per accitlent) $ PROPERTY DAMAGE Pere. ra $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 C X EXCESSLIAS CLAIMS -MADE XS20023316 8/30/2021 8/30/2022 DIEDX I RETENTION$ 0 $ 1 1 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OAPROPRIETORI FFICERIMEM EREXCLUED ECUTIVE Y❑ (Mandatory In NH) NIA WSD505815600 11/21/2020 11/21/2021 STATUTE ER E.L. EACHACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E Builders Risk ER73905160 08/30/2021 08/30/2022 Location Deductible $ 344,250 $ 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) Certificate Holder is named Additional Insured, per attached endorsement. Re: 16-6862 Cabrillo Park Drive Sidewalk Improvements SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVIShM� RbkMmcga„odOlWirn AUTHORIZED REPRESENTATIVE y @ RenenID6Awxrni®Br. 20 Civic Center Plaza 1 r' mcrAuve4 k Santa Ana CA 92701 Risk M.nage,nentspeeaht ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD