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Digitally signed"Tad Piermn
<br />Tori Pierson Date'2022.06 8124459
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<br />JRRCPIVI-VI T RY IL
<br />CERTIFICATE OF LIABILITY INSURANCE OATE(MMDDYYYY)
<br />6123/2022
<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),
<br />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
<br />provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.
<br />A statement on
<br />this certificate does not confer ri his to the certificate holder in lieu of such endorsements .
<br />PRODUCER
<br />CONTACT
<br />NFP Property & Casualty Services, Inc.
<br />1551 North Tustin Avenue
<br />PHONE
<br />(AIC, No, Ext: (714) 505-5550 FAX
<br />No :(714) 975-8966
<br />Suite 500
<br />MESS
<br />Santa Ana, CA 92705
<br />INSURERS AFFORDING COVERAGE
<br />NAIC a
<br />19038
<br />INSURER A: Travelers Casual and Sure Com an
<br />INSURED
<br />INSURER R: Travelers Commercial Insurance Company
<br />36137
<br />SRK Engineering, Inc.
<br />INSURER C:StarStone Specialty Insurance Company
<br />44776
<br />2615 Auto Park Way
<br />Esc
<br />Escondido, CA 92029
<br />INSURER D :Atlantic Specialty Insurance Company
<br />27154
<br />INSURER E :
<br />INSURER F
<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 />THEIRTYPE
<br />OF INSURANCE
<br />ADDL
<br />SUER
<br />POLICY NUMBER
<br />POLICY EFF
<br />6/25/2022
<br />6/2512022
<br />POLICY EXP
<br />6/25/2023
<br />6/2512023
<br />LIMITS
<br />A
<br />B
<br />X
<br />COMMERCIAL GENERAL LIABILITYEACH
<br />CLAIMS -MADE F X] OCCUR
<br />X
<br />X
<br />X
<br />DT-CO-3S370623-TCT-22
<br />T88104T800889-22-26�13
<br />OCCURRENCE
<br />11000,000
<br />DREAGES EREkITED
<br />300,000
<br />10,000
<br />MED EXP (Anyone arson
<br />PERSONAL&ADV INJURY
<br />$ 1,000,000
<br />GEN•L AGGREGATE LIMIT APPLIES PER
<br />POLICY ❑X JEa F]LOC
<br />OTHER
<br />AUTOMOBILE LIABILITY
<br />X ANYAUOWNED O
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOppSWWNNE�
<br />X HIREDX AUTOS ONLY
<br />X $1,000 Comp Dad
<br />X $1,000 Coil Dad
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS- COMP/OP AGG
<br />$ 2,000,000
<br />EACH EMPL
<br />COMaBINED SINGLE LIMIT
<br />1,000,000
<br />$ 11000,000
<br />BODILY INJURY Per arson
<br />$
<br />BODILY INJURY Per accident)
<br />$
<br />�20PERTV AMAGE
<br />er accitlant
<br />A
<br />X
<br />UMBRELLA LIAR
<br />EXCESS LIAR
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />S2186962226
<br />6/2512022
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />6125/2023
<br />AGGREGATE
<br />$ 10,000,000
<br />DED IX RETENTION$ 10,000
<br />A
<br />C
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANV PROPRIETORPARTNERIEXECUTIVE YIN
<br />OFFICERIMEMBER EXCLUOEOP
<br />((Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E&OlProfessional Lia
<br />leased rented equipm
<br />NIA
<br />X
<br />UB6S72376A-22.26-G
<br />86307N220APL
<br />TO BE ISSUED
<br />6125/2022
<br />6125/2022
<br />6/2512022
<br />X PER
<br />E ERH
<br />6125/2023
<br />6I2512023
<br />6/25/2023
<br />E.L. EACH ACCIDENT
<br />1+000+000
<br />E.L. DISEASE - EA EMPLOYE
<br />1,000,000
<br />E.L. DISEASE POLICY LIMIT
<br />Aggregate
<br />Ren/Lease $500000
<br />3,000,000
<br />3,000,000
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />SRK JOB # 1751 -Industrial Streets Phi Improvements, City Job # 21-6456
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Additional Insureds with respect to General and Auto Liability per the
<br />attached endorsements as required by written contract. Insurance is Primary and Non -Contributory. 30 Days Notice of Cancellation with 10 Days Notice for
<br />Non -Payment In accordance with the policy provisions.
<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 />Risk Management Division, 4th floor ACCORDANCE WITH THE POLICY PROW-"
<br />20 Civic Center Plaza - M-22 ^w k:IrMNayeaedgwen
<br />Santa Ana, CA 92701 AUTHORIZED - IEMea'®LAPAtOv®aY:
<br />%du �%r'Ordos
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<br />81 Taria-205 ACIN
<br />The ACORD name and logo are registered marks of ACORD
<br />
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