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DATE (MM/DD/YYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />3/30/2022
<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 />CONTACT
<br />PRODUCER
<br />(AVC) Donna Esquivel
<br />NAME:
<br />IOA Insurance Services
<br />FAX
<br />PHONE
<br />130Vantis, Suite 250
<br />(949) 297-5962
<br />(A/C, No):
<br />(A/C, No, Ext):
<br />Aliso Viejo, CA 92656
<br />E-MAIL
<br />donna.esquivel@ioausa.com
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGENAIC #
<br />www.ioausa.comCA License #0E67768
<br />INSURER A :RLI Insurance Company13056
<br />INSURED
<br />INSURER B :
<br />Landmark Surveying Solutions, Inc.
<br />INSURER C :
<br />7231 Boulder Avenue, Suite #538
<br />INSURER D :
<br />Highland CA 92346
<br />INSURER E :
<br />INSURER F :
<br />COVERAGESCERTIFICATE NUMBER:REVISION NUMBER:
<br />67483025
<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 />ADDLSUBR
<br />INSRPOLICY EFFPOLICY EXP
<br />TYPE OF INSURANCELIMITS
<br />POLICY NUMBER
<br />LTR(MM/DD/YYYY)(MM/DD/YYYY)
<br />INSDWVD
<br />COMMERCIAL GENERAL LIABILITY
<br />APSB00014253/13/20223/13/2023
<br />EACH OCCURRENCE$
<br />444 1,000,000
<br />DAMAGE TO RENTED
<br />Scheduled AI Endt
<br />CLAIMS-MADEOCCUR$
<br />4 1,000,000
<br />PREMISES (Ea occurrence)
<br />#PPB3130212
<br />MED EXP (Any one person)$
<br />4 Prim/NonCon10,000
<br />Professional Services
<br />PERSONAL & ADV INJURY$
<br />4 Wvr of Subr1,000,000
<br />performed by the Insured
<br />2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$
<br />are Excluded
<br />PRO-
<br />44
<br />POLICYLOCPRODUCTS - COMP/OP AGG$
<br />2,000,000
<br />JECT
<br />$
<br />OTHER:
<br />COMBINED SINGLE LIMIT
<br />AUTOMOBILE LIABILITY$
<br />APSA00012243/13/20223/13/2023
<br />1,000,000
<br />(Ea accident)
<br />44
<br />Designated Insured Endt
<br />ANY AUTO
<br />BODILY INJURY (Per person)$
<br />4
<br />#CA20481013; Prim/NonCon
<br />OWNEDSCHEDULED
<br />BODILY INJURY (Per accident)$
<br />AUTOS ONLYAUTOS
<br />and Blkt Wvr of Subr
<br />NON-OWNED
<br />HIREDPROPERTY DAMAGE
<br />$
<br />44
<br />(Per accident)
<br />AUTOS ONLYAUTOS ONLY
<br />included on pg 2 of Form
<br />$
<br />4 Prim/NonCon 4 Wvr of Subr#PPA3000313
<br />UMBRELLA LIAB
<br />APSE00012903/13/20223/13/2023
<br />EACH OCCURRENCE$
<br />4 OCCUR 5,000,000
<br />Excludes Professional
<br />EXCESS LIAB
<br />4
<br />CLAIMS-MADEAGGREGATE$
<br />5,000,000
<br />Liability; Follow Form
<br />$
<br />DEDRETENTION$
<br />PEROTH-
<br />WORKERS COMPENSATION
<br />APSW00013543/13/20223/13/2023
<br />4
<br />4
<br />STATUTEER
<br />AND EMPLOYERS' LIABILITY
<br />Y / N
<br />Waiver of Subrogation
<br />ANYP ROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT$
<br />1,000,000
<br />N / A
<br />OFFICER/MEMBER EXCLUDED?YEndt #WC0403060484
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYEE$
<br />1,000,000
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT$
<br />DESCRIPTION OF OPERATIONS below 1,000,000
<br />AProfessional LiabilityRDP00464123/13/20223/13/2023$1,000,000 Each Claim
<br />Claims-Made$2,000,000 Annual Aggregate
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Certificate Holder is an Additional Insured with respect to General Liability (GL) and Automobile Liability when required by contract with the
<br />Insured, but only to the extent provided within the Endorsements noted above. GL includes Separation of Insureds and Contractual Liability per
<br />limitations in the BusinessOwners' Coverage form. A Workers’ Compensation Waiver is included for the person or organization named in the
<br />Schedule that are parties to a written contract, but only to the extent provided within the Endorsement noted above. Coverage is subject to all
<br />policy terms, conditions, limitations and exclusions. 30 Day Notice of Cancellation / 10 Days for Non-Payment in accordance with policy provisions.
<br />CERTIFICATE HOLDERCANCELLATION
<br />Flower Street Sewer Main Improvements Santa Ana, CA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Colich & Sons, LP; City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />547W. 140th Street
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Gardena CA 90248
<br />AUTHORIZED REPRESENTATIVE
<br />(AVC) Alicia K. Igram
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />
<br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD
<br />78594136!}!4033.34!HM-!BVUP-!FYDFTT-!XD!'!QM!}!)BWD*!Epoob!Ftrvjwfm!}!404103133!5;3:;22!QN!)QEU*!}!Qbhf!2!pg!6
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