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Digitall <br />CERTIFICATE OF <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND'CofERSIM RIGHTS U � <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND —OR ALTER THE CO' El <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTIWTE A CONTRACT BETWEf�J ,'HE <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDERF% ^ � ` B �I <br />IMPURIAN I: It the certiticate holder IS an ADDITIONAL INSURED, ffB"� Cy I�m lV l <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the p Icy, certain <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement <br />PRODUCER I <br />CONTACT <br />NAME: Doris A. <br />Assured. Diablo <br />Design Professionals Insurance Services, LLC PHONE . 510: <br />Lafayette <br />Mt. Diablo Blvd Suite 230 UVC No E-MAIL <br />Lafayette CA 94549 ADDRESS: Dods.0 <br />EQ <br />INSURED <br />Group 4 Architecture <br />Research + Planning, Inc. <br />211 Linden Avenue <br />South San Francisco CA 94080 <br />COVERAGES CERTIFICATE NUMBER: 280155355 REVISION NUMBER: <br />ATE(MM/DDNYYY) <br />4/29/2022 <br />HOLDER. THIS <br />THE POLICIES <br />, AUTHORIZED <br />on <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 />ADDLSUBR <br />POLICYNUMBER <br />POLICY EFF <br />MWDDNYYY <br />POLICY UP <br />MWDD <br />LIMITS <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />6803,1225448 <br />7/18/2021 <br />711a=2 <br />EACH OCCURRENCE <br />$Z,000,OOO <br />CLAIMS -MADE � OCCUR <br />D TED <br />PREMISES Ea omunence <br />$7,000,000 <br />MED UP Any one person <br />$ 10.000 <br />PERSONAL&ADV INJURY <br />$2.000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$4,000,000 <br />POLICY E JECT PRO- ❑ LOC <br />PRODUCTS-COMPK)P AGG <br />$4,000,000 <br />$ <br />OTHER: <br />C <br />AUTOMOBILE <br />LIABILITY <br />Y <br />Y <br />BA9R464848 <br />7/18/2021 <br />V18/2022 <br />COMBINED SINGLE LIMIT <br />Ea eroklent <br />$1,00➢,00➢ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />X <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />B <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />Y <br />Y <br />CUP9G286032 <br />7/18/2021 <br />7/18/2022. <br />EACHOCCURRENCE <br />$4,000,000 <br />AGGREGATE <br />$4,000,000 <br />EXCESS LUIB <br />CLAIMS -MADE <br />DED I I RETENTION <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />PER I I OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />ANYPROPRIETORIPART,IERIEXECUTIVE ❑ <br />OFFICEMMEMBER EXCLUDED'! <br />NIA <br />E.L. DISEASE -EA EMPLOYEE <br />$ <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE- POLICY LIMIT <br />$ <br />A <br />Professional Liability <br />DPR9981301 <br />7/22/2021 <br />7/22/2022 <br />$2,000,000 per Claim <br />Claims Made <br />$2,000,000 Ann) Aggr. <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is re9ulmd) <br />The Excess -Umbrella Liability is Following Form to the General Liability and Automobile Liability policies. <br />REF:. Santa Ana Library/ 22575-01 - Santa Ana Main Library Renovation, Santa Ana GENERAL LIABILITY/AUTOMOBILE LIABILITY ADDITIONAL INSURED: <br />The City, its officers, officials, employees, and volunteers are named as Additional Insured as respects General Liability and Auto Liability as required per <br />written contract or agreement. General Liability is Primary/Nan-Contributory per policy form wording Waiver of Subrogation applies to Commercial General <br />Liability and Automobile Liability. ProfessionalLiability Retro Date: Professional Liability Prior Acts Date 01/01/1974. Notice of Cancellation: It is understood <br />and agreed that in the event of cancellation of the policy for any reason other than nonpayment of premium, 30 days written notice will be sent to the certificate <br />holder by mail. In the event the policy is cancelled for non payment of premium, 10 days written notice Will be sent to the above. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <br />of Prem <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 />AUTHDRO:EO EPREBENTATIVE <br />©1988-2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Rlek Menaganin tt DMillon <br />REvIEwED & APPRcvm BY: <br />A� Acwu1+: <br />Risk Management Speda ist <br />Of <br />