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QUALFEN-02
<br />MA U
<br />,a41.. R w CERTIFICATE OF LIABILITY INSURANCE
<br />DAT/15/2022 Y)
<br />7115/2022
<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(iss) 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 # OC36861
<br />rncr Beverly Goyen
<br />Inland Empire-Alliant Insurance Services, Inc.
<br />685 E. Carneie Dr Ste 265
<br />g
<br />San Bernardino, CA 92408
<br />PHO IJ o, Eat): (909) 886-9661 �A/c, No):(909) 886.2013
<br />UpA1IESS; bgoyen@alliant.com
<br />INSURERS AFFORDING COVERAGE
<br />NAICIf
<br />INSURER A: Mt. Hawley Insurance Company,37974
<br />INSURED
<br />INSURER B: Allstate Insurance Company
<br />19232
<br />INSURER C:Cypress Insurance Company
<br />10855
<br />Quality Fence Company, Inc
<br />INSURER D:
<br />14929 Garfield Avenue
<br />Paramount, CA 90723
<br />INSURER E ;
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER -
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICYPERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOROTHER DOCUMENTWITH 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 />ADD_INSOL
<br />SUBp
<br />POLICY NUMBER
<br />POLICDY EFF
<br />POLICY EXPLTR
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />MGLO195573
<br />10/112021
<br />10/1/2022
<br />EACH OCCURRENCE
<br />1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Eaccc r
<br />50,000
<br />GEN'L
<br />X
<br />MED EXP (Any oneperson)
<br />$ 5,000
<br />PERSONAL B ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY � JECT LOG
<br />OTHER: 5,000,000 per proj. cap.
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMP/OP AGG
<br />$ 2A00,000
<br />EBL AGG
<br />11000,000
<br />B
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOpSSWW
<br />AUTOS ONLY X AUTOSONLY
<br />X
<br />648909969
<br />10/112021
<br />10/1/2022
<br />COMBINED SINGLE LIMIT
<br />accident
<br />1,000,00g
<br />BOD ILLY INJ URY PerPerson)
<br />BODILY INJURY Per accident
<br />Pe�acd�nl AMAGE
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />MXL0431792
<br />10/1/2021
<br />101112022
<br />EACH OCCURRENCE
<br />$ 8,000,000
<br />AGGREGATE
<br />$ 8,000,000
<br />DED I X I RETENTION$ O
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNEWEXECUTIVE YIN
<br />QFFICER/MEMW,& EXCLUDEDP ❑Y
<br />antle ory In
<br />If yes, describe under
<br />OF OPERATIONS below
<br />N/A
<br />X
<br />QUWC202153
<br />10/1/2021
<br />101112022
<br />PER OTH-
<br />X TUTE ER
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000DESCRIPTION
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required)
<br />Re: Job #22-6469, Stormwater Channel Fencing Upgrades
<br />City of Santa Ana, Its officers, employees, agents and representatives are additional Insureds, primary and non-contributoryas respects to general liability
<br />per endorsements attached; additional Insureds, primary and non-contributory as respects to auto IlabiIIty per endorsements attached; waiver of subrogation
<br />as respects to workers' compensation per endorsement attached. Cancellation notice per attached endorsements.
<br />CERTIFICATE HOLDER r:ANr:Fi I ATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Cityof Santa Ana
<br />Risk Management Division, 4th Floor
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />V/''k PLAI,
<br />ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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