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A� o CERTIFICATE OF LIABILITY INSU �e Digi <br />all"'21 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS ON THE Cr:RJI.`14f(AiC EIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER T IISSdd 14LOf5 i <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BET 1l•.�tl VIE 44F. �,®IJfQJI�IRIZED <br />= <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 NO.0637431 <br />PATRICK MCRAE INSURANCE SERVICES <br />1265 N. MANASSERO ST. SUITE 303 <br />ANAHEIM HILLS, CA 92807 <br />CONTACT NAME: pATRICK MCRAE <br />PHONE <br />E (714) 779-6999 FAX Net: (714) 779-6903 <br />EMAIL q ADDRESS: centre uest mcrdeinsurance.insure <br />INSURERS AFFORDING COVERAGE <br />NAIC N <br />INSURERA: NAVIGATORS SPECIALTY INSURANCE CO. <br />36056 <br />INSURED <br />INSURERS: INSURANCE COMPANY OF THE WEST <br />27847 <br />INSURER c: INTEGON NATIONAL INSURANCE COMPANY <br />29742 <br />CROSSTOWN ELECTRICAL & DATA, INC. <br />5454 DIAZ STREET <br />IRWINDALE CA 91706 <br />INSURER0: ATLANTIC SPECIALTY INSURANCE COMPA <br />27154 <br />INSURERE: GREAT AMERICAN INSURANCE CO. <br />16691 <br />INSURERF: <br />CERTIFICATE 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 />ILTR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />INSDIMDI <br />POLICYNUMBER <br />POLICY EFF <br />MMrD <br />POLICY EXP <br />MWD <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />XCU <br />X <br />X <br />LA2ICGLZ04TP71C. <br />DEDUCTIBLE $5,000 PER <br />OCCURENCE <br />09/03/202109/0312022 <br />EACHOCCURRENCE <br />$ 1,000,000 <br />DA GE TO RE ED <br />PREMISES Eaoccurrenca <br />$ 100,000 <br />X <br />MED EXP (Any one arson) <br />$ 5.000 <br />CCP <br />PERSONAL &AOV INJURY <br />$ 1,000,000 <br />X <br />AGGREGATE LIMIT APPLES PER <br />POLICYI JET D LOC <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L <br />PRODUCTS-COMP/OP ADD <br />$ 2,000,000 <br />EBL <br />$ 1.000.000 <br />OTHER <br />C <br />AMOMOBILELIABILITY <br />X <br />X <br />ANY AUTO <br />AUTOS ONLY X AUHOSULED <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />X <br />X <br />2005675448 <br />COMP: $1,000 <br />COLL: $1.000 <br />11/05/2021 <br />11/05/2022 <br />COMBINED ISINGLE LIMIT <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ _ <br />BODILY INJURY (Per accident) <br />$ _ <br />PROPERTYDAMAGE <br />P accident <br />$ - <br />E <br />X <br />UMBRELLALUB <br />EXCESS LIAR <br />X <br />OCCUR <br />CLAIMS -MADE <br />TUE 2572052 03 <br />UNDERLYING LIMITS: <br />GL; AL; EL POLICIES <br />06/03/2021 <br />09/03/2022 <br />EACH OCCURRENCE <br />$ 10,000,000 <br />AGGREGATE <br />$ 10.000,000 <br />X <br />DELI <br />RETENTION$ 0 <br />$ <br />B <br />ANOEMPLOYMSENSATN YIN <br />OFFICERMEM ERE OWAWROPRIETOWPARTNERIOEEXEOCUTIVE <br />(Mandatory in NH) <br />UDESCRIPTION OF OPERATIONS below <br />N/A <br />x <br />WVE 5030354-07 <br />06/031202206/03/2023X <br />STATUTE ERH <br />E.L. EACH ACCIDENT <br />$ 1,000.000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 1,000,000 <br />EA_ DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />D <br />{ <br />PROPERTY & <br />CONTRACTORS <br />710039414 <br />81,000 DEDUCTIBLE <br />COV. INCL. THEFT <br />05/10/202 <br />5/10/202 <br />Ds <br />51,41AM P.,noywl P,emius <br />Se0 WO Laautl BPP <br />wemaai <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD IDI, Additional Remarries Schedule. maybe attached if more space is required) <br />CITY OF SANTA ANA IS NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED <br />ENDORSEMENT(S). COVERAGE IS PRIMARY & NONCONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT <br />FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. <br />`SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL <br />BE ISSUED. <br />RE: ON CALL CONSTRUCTION SERVICES FOR TRAFFIC SIGNALS, STREET LIGHTS AND CONCRETE WHEELCHAIR RAMPS, PROJECT #RFP NO: 21- <br />095, JOB #TBO <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />20 CIVIC CENTER PLAZA, M-43 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />SANTA ANA, CA. 92701 ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />d. <br />IJ 1966-2015 ACORD (- <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Rhx Management speamst <br />