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VCACONS-01 MCCOWANA
<br />,d►c CERTIFICATE OF LIABILITY INSURANCE
<br />��
<br />DATE(M
<br />6/28/202YYY)
<br />2024
<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 'ieu uch endorse t(s).
<br /># OE67768
<br />PRODUCER AA9
<br />3636 Nobe
<br />IOA Insurangie
<br />Suite 410
<br />San Diego, Al
<br />P AX
<br />( , No, Ext): (61 788-57 50206 (A/c, No):(619) 574-6288
<br />E-MAIL it u o
<br />lyllt=i.S
<br />S F
<br />ERAGE
<br />NAIC #
<br />INSURER A : Travelers Property Casualty Company of America
<br />25674
<br />INSURED . T I S r nc C an
<br />C It I INa.. =4c F F nti errini or oration
<br />SC. afl am sur /
<br />18 Or ewoo e, ult s
<br />Orange, 9 O INSUR _UU_
<br />INSURER F
<br />29459
<br />11380
<br />COVERAGES CERTIFICATE NUMBFR- REVISION NLIMBFR-
<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 />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE X OCCUR
<br />X
<br />X
<br />6801R291569
<br />7/1/2024
<br />7/1/2025
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />1,000,000
<br />$
<br />X
<br />MED EXP (Any oneperson)
<br />$ 5,000
<br />Cont Liab/Sev of Int
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GENT
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY X 71 PEt° LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />Ded
<br />$ 0
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />CMBINED SINGLE LIMIT
<br />EaOaccident
<br />1,000,000
<br />$
<br />X
<br />BODILY INJURY Perperson)
<br />$
<br />ANY AUTO
<br />X
<br />BA9P831412
<br />7/1/2024
<br />7/1/2025
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accident
<br />$
<br />PROPERTY DAMAGE
<br />Per accident)
<br />ccident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />X
<br />Comp.: $1,000 X Coll.: $1,000
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />CUP1R295206
<br />7/1/2024
<br />7/1/2025
<br />AGGREGATE
<br />$ 5,000,000
<br />DED RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N / A
<br />X
<br />72WEGAM3JXV
<br />7/1/2024
<br />7/1/2025
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />C
<br />Professional Liab.
<br />USF00847424
<br />7/1/2024
<br />7/1/2025
<br />Per Claim
<br />2,000,000
<br />C
<br />Ded $50,000 Ech Clm
<br />USF00847424
<br />7/1/2024
<br />7/1/2025
<br />Aggregate
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Named Insured Includes: dba VCA Structural; dba VCA Consultants; Van Dorpe Chou Associates, Inc.; The Code Group, Inc.; dba VCA Green; dba VCA Code;
<br />dba VCA Code Group, , The Code Group, Inc. dba: Verde, The Code Group, Inc. dba: Verde, a VCA Company. The Umbrella policy is follow -form to the
<br />underlying GL, Auto and WC policies.
<br />Re: All Operations
<br />City of Santa Ana, officers, agents, employees, and volunteers are Additional Insureds with respect to General and Auto Liability per the attached
<br />SEE ATTACHED ACORD 101
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREO
<br />ACCORDANCE WITH THE POLICY PRG RAManagmumtDMsIan
<br />z, REVIEWED& APPROVED BY: �y
<br />City of Santa Ana AUTHORIZED REPRESENTATIVE °�1_If�d,a_I_�YCL' /"I'3 u / avdo
<br />Risk Management Division R .
<br />20 Civic Center Plaza_+ Risk Management Specialist
<br />0--.- A. nA Oe7Ae
<br />ACORD 25 (2016/03) © 1988-2015 ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />
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