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 />
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