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ACC?R o® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DDIYYYY)
<br />02/13/2023
<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 poliey(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 endorsement(s).
<br />PRODUCER
<br />CONTACT Colleen Woods
<br />NAME:
<br />PHONE (619) 683-9990 (619) 683-9999
<br />AIC No Ezt : AIC, No
<br />Michael Ehrenfeld Company Insurance Agents
<br />An Acrisure Agency CA OK07568
<br />E1,tAIL cwoods ehrenfeldinsurance.com
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICR
<br />2655 Camino Del Rio North #200
<br />San Diego CA 92108
<br />INSURERA: Travelers Indemnity Company Of CT
<br />25682
<br />INSURED
<br />INSURER B: Travelers Property Casualty Co Of America
<br />25674
<br />GMZ Engineenng, Inc.
<br />INSURER C: Evanston Insurance Company
<br />35378
<br />5655 Undero Canyon Road, #430
<br />INSURER D:
<br />MSURER E:
<br />Westlake Village CA 91362
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 22-23 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 MAYBE 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 />ADUL
<br />INSD
<br />SUO
<br />POLICY NUMBER
<br />PO CYEFF
<br />h1MA)D
<br />MOLIC
<br />POLICY EXP
<br />LWITS
<br />COMMERCIALGENERALLIABILITY
<br />CCURRENCE
<br />$ 1.000.000
<br />CLAIMS -MADE ® OCCUR
<br />DAMAGE FORENIED
<br />ES Eaaccerence
<br />$ 300,000
<br />P (Anyone person)
<br />g 5,000
<br />Deductible$5,000
<br />1,000,000
<br />A
<br />Y
<br />Y
<br />CO9P4073DO
<br />06/01/2022
<br />06/01/2023
<br />NAL&ADV INJURY
<br />rN
<br />$
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />ALAGGREGATE
<br />$ 2,000.000
<br />POLICY ❑X JEOT LOC
<br />CTS-COMPIOPAGG
<br />$2,000,000
<br />yee Benefits Liab
<br />$ 2,000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILRY
<br />ED SINGLE LIMIT
<br />Ea .cadent
<br />$ 1,000,000
<br />BODILY INJURY (Par person)
<br />$
<br />ANYAUTO
<br />g
<br />OwNEO SCHEDULED
<br />Y
<br />Y
<br />BA9P404033
<br />06/01/2022
<br />06101/2023
<br />'BODILY INJURY (par acadenq
<br />$
<br />AUTOS ONLY AUTOS
<br />PROPERTY DAMAGE
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />Per .cadent
<br />Comp/Coll Deductible
<br />S 1.000
<br />UMBRELLAUAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000.000
<br />B
<br />EXCESS LIAB
<br />CINMS-MADE
<br />CUP9P41105A
<br />06/0112022
<br />06/01/2023
<br />AGGREGATE
<br />$ 5,000,000
<br />DED
<br />RETENTION S 10.000
<br />$
<br />WORKERS COMPENSATION
<br />PER OTH-
<br />AND EMPLOYERS' LIABILITY YIN
<br />ON STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />B
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />Y
<br />UB9P402654
<br />O6/01/2022
<br />O6/01/2023
<br />E.L.DISEASE-EAEMPLOYEE
<br />$ 1,000,000
<br />(Mandatory In NH)
<br />Ityes. describe under
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />E.L DISEASE - POLICY LIMIT
<br />E
<br />Schedule Equipment
<br />$1.785,423
<br />Inland Marine
<br />A
<br />Y
<br />C09P407300
<br />06/01/2022
<br />06/01/2023
<br />Rented/Leased Equip
<br />$620,000
<br />Deductible
<br />$1,000
<br />DESCRIPTIONOFOPERATIONSILOCATIONSIVEHICLES (ACORD 111. AdEUtonal Remarks Schedule, may be attached ifmore space is required)
<br />[Job #: 22-6622 Job Type: Downtown Flood Reduction & Stormwater Infiltration)
<br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701, its officers, employees, agents, volunteers, and representatives are named as
<br />additional insureds ("additional insureds'), primary/noncontributory and waiver of subrogation as indicated above with regard to liability and defense of suits
<br />arising from the operations and uses performed by or on behalf of the named Insured. Endorsements only apply as required by written contract.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana / Public Works Agency
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaze (M-36)
<br />AUTHOREED REPRESENTATIVE
<br />RossAnnex
<br />Santa Ana CA 92701
<br />�7
<br />-'i(t
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<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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