|
Client#: 475947
<br />Digital
<br />DATE(MMIDD/YYYY)
<br />b 2/30/2021
<br />ACORD,. CERTIFICATE OF LIABILITY IN44gX�
<br />si ned
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE C 'R F'j� 0707
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER T//AE COVERAGE AF' f ? }
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BET NCR 1{. NSIM@! AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. `� V
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL IN .URED ^- endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies m requi• a an :,,o r T Ilaternent on
<br />3.�:�:35
<br />this certificate does not confer any rights to the certificate holder in lieu of such endorsem S
<br />PRODUCER
<br />Marsh & McLennan Agency LLC
<br />Marsh &McLennan Ins. Agency LLC
<br />350 S Grand Ave, Ste 3410
<br />Los Angeles, CA 90071
<br />CONTACT Nicho - I" ' '
<br />NAME:
<br />a020, at, 949 425 7? f2 FAX
<br />A/C. No:
<br />ADDRIESS, nick.newell@marshmma.com
<br />INSmeric J
<br />NATO M
<br />InsuranceNG
<br />CompanERAGEy
<br />INSURER A: Landmark American Insurance Company
<br />33738
<br />INSURED
<br />All City Management Services, Inc.
<br />10440 Pioneer Blvd., Suite 5
<br />Santa Fe Springs, CA 90670
<br />INSURER B : Mercer Insurance Company
<br />14478
<br />Berkshire Hathaway Homestate Ins Co
<br />INSURER C : Y
<br />20044
<br />INSURER D : Lexington Insurance Company
<br />19437
<br />INSURER E: P Westchester Surplus Lines Insurance Co
<br />10172
<br />INSURER 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 CONTRACTOR 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 />ADDLSUB
<br />INSR
<br />MD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMIDD/1'YYY
<br />POLICY EXP
<br />MMMD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL L ABILITY
<br />LHA141591
<br />0810112021
<br />08/0112022
<br />EACH
<br />$1000000
<br />CLAIMS -MADE N OCCUR
<br />�OCCCTURRENCE
<br />PREISES ERE u Dnce
<br />$50000
<br />MED EXP (Anyone pemrsn)
<br />$5,000
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLI ES PER:
<br />X POLICY 1-1JEC LOC
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />PRODUCTS-COMP/OPAGG
<br />0
<br />$2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />BODILY INJURY (Per parson)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY( Par accident)
<br />$
<br />HIRED NON-0WNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />B
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />20000000182
<br />8/01/2021
<br />08/01/2022
<br />EACH OCCURRENCE
<br />$3 000 000
<br />AGGREGATE
<br />s3,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I I RETENTION$
<br />$
<br />C
<br />C
<br />WORMERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNERIEXEC"VE
<br />OFFICERIMEMBER EXCLUDED? N
<br />NIA
<br />ALWC344179
<br />ALWC345830
<br />1/01/2022
<br />1/01/2022
<br />01/01120
<br />01/0112023
<br />X PER OTH-
<br />E.L. EACH ACCIDENT
<br />$1,000000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />D
<br />1st Excess Layer
<br />080877908
<br />8101/2021
<br />0810112022
<br />$1,000,000
<br />E
<br />2nd Excess Layer
<br />G72535522001
<br />8/01/2021
<br />08101/2022
<br />$5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />GL General Aggregate Limit: $5,000,000
<br />GL applies on a per project basis.
<br />City of Santa Ana, officers, agents, employees, and volunteers are included as additional insured as
<br />respects to General Liability per attached endorsement. Primary and Non -Contributory
<br />Wording applies per attached endorsement. Cancellation provisions apply per the attached.
<br />City of Santa Ana
<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 PROVISIONS.
<br />Santa Ana, CA 92701-0000
<br />AUTHORIZED REPRESENTATIVE
<br />Pt-uc k4Is41
<br />©1988-2015 ACORC
<br />ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S9127217/M9113004
<br />Risk Managenwad Division
<br />REVIEwED 6 APPROVED BY:
<br />��'. Ayer A44W44
<br />- Risk Management Specialist
<br />
|