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Digitally signed by Tori Pierson
<br />Tori Pierson Date: 2022.06.0911:2509
<br />-07' q'
<br />AcoRo® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDD YYYY)
<br />05/13/2022
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT Ki
<br />NAME: mbal Beene
<br />Newfront Insurance Services, LLC
<br />PHONE (415) 754-3635 ac No
<br />450 Sansome Street
<br />�Mp l .E. kimbal.beene@newfront.com
<br />Suite 300
<br />-
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />San Francisco CA 94111
<br />INSuRERA: Philadelphia Indemnity Ins Co
<br />18058
<br />INSURED
<br />INSURER B: Clear Blue Specialty Ins CO
<br />37745
<br />INSURER - NorGUARD Insurance Company
<br />31470
<br />Cinguard, Inc - -
<br />INSURER D:
<br />22736 Vanowen St Ste 300
<br />West Hills CA 91307
<br />E
<br />INSUNSURERRER F
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 />Lm
<br />TYPE OkINSURANCE
<br />ADDL
<br />SUBR
<br />POLICYNUMBER
<br />POLICY BEE
<br />MWDD/YYYY
<br />POLICY EXP
<br />MWDO
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Eaoccunence
<br />$ 1,000,000
<br />MED EXP (Any oneperson)
<br />$ 20,000
<br />PERSONAL B ADV INJURY
<br />$ 500,000
<br />A
<br />X
<br />X
<br />PHPK2396185 1
<br />03/26/2022
<br />03/26/2023
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY X JECT LOG
<br />GENERALAGGREGATE
<br />$ 31000,000
<br />GEN'L
<br />I
<br />PRODUCTS -COMPIOPAGG
<br />$ 3,000,000
<br />PER PROJECT AGGREGATE
<br />$ 5,000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />A'
<br />AALLOSNED SCHEDULED
<br />X
<br />X
<br />PHPK2396185
<br />03/26/2022
<br />03/26/2023
<br />BODILY INJURY(Peraccident)
<br />$
<br />HIRED AUTOS AUTOSWNED
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />-
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />B
<br />EXCESS LIAB I
<br />CLAIMS -MADE
<br />X
<br />X
<br />WCSECEL000200601
<br />04/13/2022
<br />03/26/2023
<br />DED I I RETENTIONS
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROPRIETORIPARTNERIEXOFFCERIMEVIB REXCLUDEOTECUTIVE
<br />N/A
<br />X
<br />CIWC326930
<br />03/26/2022
<br />03/26/2023
<br />PER OTH.
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory In NH) -
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />-
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />Errors and Omissions:
<br />Each Occurrence $1,000,000
<br />A
<br />-
<br />PHPK2396185
<br />03/26/2022
<br />03/26/2023
<br />Aggregate $3,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, AddlUonal Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written Contract, agreement, or
<br />memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and
<br />noncontributory. 30 days notice of cancellation applies. Coverage is Primary and Non -Contributory. Per Project general aggregate limit applies. Waiver of
<br />subrogation applies in favor of the certificate holder with respect to General Liability, Auto Liability, and Workers Compensation.
<br />1'q=IAIIyftlAf
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Piz FI 4
<br />Santa Ana
<br />ACORD 25 (2014101)
<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 />AUTHORIZED REPRESENTATIVE
<br />/ Rirk Mvgewlt Okiaion
<br />�« ';t RE�aerFDG ArrRw®er.
<br />ACORD CORP' ' %du {{JrcWox
<br />The ACORD name and logo are registered marks of ACORD-Rhkma„age„e„mmulade
<br />CA 92701
<br />
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