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MBREYEL-01 NGARCIA
<br /> ACORO CERTIFICATE OF LIABILITY INSURANCE DATE 1
<br /> 2/13/213/2025
<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 CONTACT Noemi Garcia
<br /> NAME:
<br /> Orion Business Insurance and Risk Management Services,Inc. PHONE 626 773-8488 FAX 951 737-5083
<br /> 1250 Corona Pointe Court,Suite 302 (A/C,No,Ext):( ) (A/C,No):( )
<br /> Corona,CA 92879 E-MAIL ngarcia@orionins.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURERA:CanO ius US Insurance Inc. 12961
<br /> INSURED INSURER B:National Fire &Marine Insurance Company 20079
<br /> M. Brey,Inc.,dba MBE Construction INSURER C:Everest Premier Insurance Company 16045
<br /> P O Box 3159 INSURER D:
<br /> Beaumont,CA 92223
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM/DD/YYYY MM/DD/YYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR CUSPC19000173-00 11/13/2024 11/13/2025 DAMAGE TO RENTED 100,000
<br /> X X PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ Excluded
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY� JECT1:1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> X OTHER:$5,000 BI/PD Ded per Occ $
<br /> B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> ANY AUTO X 72APBO10033 11/13/2024 11/13/2025 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY X AUTOS BODILY INJURY Per accident $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> X EXCESS LIAB CLAIMS-MADE CUSXS20000077-00 11/13/2024 11/13/2025 AGGREGATE $ 5,000,000
<br /> DED RETENTION$ $
<br /> C WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> 7600026637251 2/12/2025 2/12/2026 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ X E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Digitally si9nz I
<br /> Tu Tran by TU Tran
<br /> N uyen D9 20 APPROVED
<br /> 15 02.43-09 01 8
<br /> 15:02:43-OS'0'
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 1D1,Additional Remarks Schedule,may be attached if more sp By TO Tran Nguyen at 3:01 pm, Feb 18, 20425
<br /> Project No:PO 7933
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are listed as additional insureds as respects General Liability and
<br /> Auto Liability with respect to liability arising out of work operations performed by or on behalf of Contractor including materials,parts,and equipment
<br /> furnished in connection with such work or operations and automobiles owned,leased,hired,or borrowed by or on behalf of Contractor.Primary wording is
<br /> included as respects General Liability per the attached policy form.Waiver of subrogation is included as respects General Liability and Workers'
<br /> Compensation per the attached policy forms.Notice of cancellation will be delivered in accordance with the policy provisions.
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn: Public Works Agency,Water Resource Division
<br /> 215 S.Center Street(M-85)
<br /> Santa Ana,CA 92701 A'UUTTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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