|
ay oo:�
<br />PAULUS ENG JLOPF7
<br />'4� CERTIFICATE OF LIABILITY INSURANCE 15-
<br />DAT/281202YYY)
<br />4/2812022
<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
<br />Commercial The Brokerage
<br />The Brokerage, an Alera Group Company
<br />20261 SW Acacia St, Suite 200
<br />CONTACT JeSSICa Lopez
<br />PHONE FA%
<br />A/c, No, Eat): (949) 287-5677 A/c, No :(949) 335-0621
<br />ADDRESS: jlopez@thebrokerageins.com
<br />Newport Beach, CA 92660
<br />INSURERS AFFORDING COVERAGE
<br />NAIL 0
<br />INSURER A: Executive Risk Indemnity, Inc.
<br />35181
<br />INSURED
<br />INSURER B: Federal Insurance Company
<br />20281
<br />INSURER C :
<br />Paulus Engineering, Inc.
<br />INSURER D :
<br />2871 E. Coronado Street
<br />Anaheim, CA 92806
<br />INSURER E
<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 />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXPLTR
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE LX] OCCUR
<br />X
<br />54303105
<br />5/1/2022
<br />5/112023
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGETO
<br />OaccNTc mD
<br />EREMISEMED
<br />$ 100,000
<br />EXP (Any one erson
<br />$ 5,000
<br />PERSONAL B ADV INJURY
<br />1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY PEA LOC
<br />OTHER:
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS-COMP/OP AGO
<br />1 2,000,000
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />WVy
<br />AUTOS ONLY AUOTOSONED
<br />54303104
<br />511/2022
<br />5/112023
<br />WMaBI dim SINGLE LIMIT il
<br />$ 1,000,000
<br />X
<br />BODILY INJURY Per erson
<br />$
<br />BODILY INJURY Per accident
<br />$
<br />Pe�amitlenl AMAGE
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />OCCUR
<br />CLAIMS -MADE
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />DED RETENTION$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
<br />(ManEatoryEn NH)CLUDED?
<br />Ryes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />54303106
<br />5/112022
<br />5/1/2023
<br />X PER OTH-
<br />E
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYE
<br />1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />RE: Master Agreement #A-2019-142-02; Agreement #A-2020-091-02; Santa Ana Emergency Work. glaip
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are Named as Additional Insureds as respects General Liability per
<br />Attached Endorsement.
<br />This Insurance shall apply as Primary and Non -Contributory per attached endorsement.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE
<br />THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROM""'-'^
<br />,..°e-... RhkMosgenedllMI
<br />`4
<br />AUTHORIZED REPRESENTATIVE
<br />y' REMEV,ID6APPItOJ®B[
<br />C�
<br />Tau �itCl yr
<br />Risk Mana9e,ms, Cle,ir.,IAiAe
<br />ACURU 25 (20 b1U3) U 1988-2015 ACORD C( IC
<br />The ACORD name and logo are registered marks of ACORD
<br />
|