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Tori Pierson Date 2G22.0 le 1240:seeson
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<br />ENVIPLA-n2 RHOITFR
<br />A`.i t CERTIFICATE OF LIABILITY INSURANCE
<br />DATE DIYYYY)
<br />s1s/2o22
<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 endorsements .
<br />PRODUCER License QE67766
<br />IDA Insurance Services
<br />3875 He yard Road -
<br />Suite 200
<br />CONT
<br />ME: ACT David Sifuentes
<br />PHONE FAX
<br />(AIc, No, 1(925) 660-3507 LAIC, No):(925) 416-7869
<br />ADDRESS: David.Sifuentes@ioausa.com
<br />Pleasanton, CA 94588
<br />-
<br />INSURERS AFFORDING COVERAGE
<br />NAICe
<br />INSURER A: Continental Casualty Company
<br />20443
<br />INSURED :
<br />INSURER B: Hartford Casualty Insurance Company
<br />29424
<br />Environment Planning Development Solutions Inc dba EPD
<br />- Solutions Inc
<br />INSURER C :
<br />2355 Main Street Suite 100
<br />INSURER D :
<br />INSURER E
<br />Irvine, CA 92614
<br />NSURER 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 />TYPE OF INSURANCE.
<br />ADDL
<br />INSD
<br />SUBR
<br />Wife
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY UP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ry OCCUR
<br />X
<br />X
<br />B6.025654530
<br />6/23/2022
<br />6/23/2023
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />DAMAGE TO RENTED
<br />PREMISES (Ea occugence)
<br />1,000,00
<br />$
<br />MED UP (Any one persom
<br />$ 10,000
<br />PERSONAL&ADV INJURY
<br />2,000,000
<br />GEHL
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY j �T LOC
<br />GENERAL AGGREGATE
<br />4,000,000
<br />PRODUCTS - COMP/OP AGO
<br />4A00,00
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED dard,SINGLE LIMIT
<br />is
<br />$i 1,000,000
<br />BODILY INJURY PerPerson)
<br />s
<br />ANYAUTO
<br />X
<br />X
<br />B6025654530
<br />6/2312022
<br />6/23/2023
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUUT�OpS
<br />BODILY INJURY Per accident
<br />ParracclRtlent AMAGE
<br />$
<br />X
<br />AUTOS ONLY X AUTOS ONLY
<br />A
<br />X
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />4,000,000
<br />X
<br />AGGREGATE
<br />4,000,000
<br />EXCESS LIAB
<br />CIAIMS-MADE
<br />X
<br />X
<br />B 6025663132
<br />6/2312022
<br />6/23/2023
<br />DED X RETENTION$ 10,000
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROP RIETORIPARTNERIEXECUTIVE YIN
<br />WQO
<br />FICER/M%R EXCLUDED? ❑N
<br />`Mandatary in NH)
<br />ayes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />X
<br />57 WEG AC20BW
<br />- -.
<br />9/3012021
<br />913012022
<br />PER OTH-
<br />X E
<br />E.L.. . EACH ACCIDENT
<br />1,000,
<br />E. L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />A
<br />Professional Liab.
<br />X
<br />EEH591923312
<br />9/3012021
<br />913012022
<br />Per Claim
<br />2,000,000
<br />A
<br />Professional Liab.
<br />X
<br />EEH591923312 -
<br />9/3012021
<br />9/30/2022
<br />Aggregate
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />City of Santa Ana is included as additional Insured on Commercial General Liability and Hired and Non -Owned Auto Liability, as required by written contract.
<br />Waiver of Subrogation andPrimaryand Non -Contributory Provision included on Commercial General Liability Policy, as required by written contract. Waiver
<br />of Subrogation Provision included on Workers Compensation policy, as required by written contract -Commercial Excess Liability policy follows form With the
<br />Commercial General Liability, Hired and Non -Owned Auto Liability and Employers Liability Policies. and Employers Liability Policies. Should any of the above
<br />described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. Professional Liability is a
<br />claims made policy and includes Waiver of Subrogation Provision as required by written contract.
<br />30-Day Notice of Cancellation is included per policy provisions.
<br />City of Santa Ana
<br />Risk Management Divison
<br />20 Civic Center Plaza, 4th Floor
<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 PROV
<br />y,
<br />AUTHORIZED REPRESENTATIVE ` REv1LwEDi APmoaID Br.
<br />V�-t` ` 2uN Managnmrt<Iniral Aide
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CC I V
<br />The ACORD name and logo are registered marks of ACORD
<br />
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