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Client#:180949 CTCAMERTraf\7 Digitally signed <br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE .Jacobs rL MAW.", <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 any rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT Commercial Support <br />Edgewood Partners Ins. Center <br />n/cDNN Eat:631 324-1440 A C, No: <br />40 Marcus Drive <br />ADDRESS: NECertificates@epicbrokers.com <br />3rd Floor <br />Melville, NY 11747 <br />INSURER(S)"FORDING COVERAGE <br />NAIC# <br />INSURER A: Beazley Insurance Company, Inc. <br />37540 <br />INSURED <br />INSURER a: Twin City Fire Insurance Company <br />29459 <br />LAD (Aviation), Inc. dba Charles Taylor <br />INSURER C: Canopy <br />Environmental Technical Services <br />INSURER o: Allianz Underwriters Insurance Company <br />36420 <br />5850 San Felipe Street, Suite 500 <br />Houston, TX 77057 <br />INSURER E: <br />INSURER 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 CONTRACTOR 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 />LTR <br />TYPE OF <br />ADDLSUB <br />INSR <br />MD <br />POLICY NUMBER <br />POLICY EFF <br />MWDD/YYYY) <br />POLICY UP <br />(MWDDNYYYI <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />Y <br />Y <br />ENC000915201 <br />10/31/2022 <br />10/31/2023 <br />EACH OCCURRENCE <br />$1,000000 <br />PREMISES Ea ocet ante <br />$100000 <br />MED UP (Any one person) <br />$25 000 <br />PERSONAL It ADV INJURY <br />$1,000,000 <br />GEWL <br />AGGREGATE LIMIT APPLIES PER: <br />PRO - <br />POLICY X-JECT X LOG <br />GENERALAGGREGATE <br />$2,000,000 <br />PRODUCTS - COMP/OP AGG <br />$2,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />12UENGC3953 <br />5/01/2022 <br />05/01/202 <br />EeaBINEDtSINGLELIMIT <br />$1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />X <br />ANY AUTO <br />AUTOS ONLY AUTOSSCHED ULEO <br />BODILY INJURY(Pmaccided) <br />$ <br />X <br />AUTOS ONLY X NON -OWNED <br />AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />A <br />X <br />UMBRELLAUAa <br />X <br />OCCUR <br />ENX000915301 <br />10/31/2022 <br />10/31/202 <br />EACH OCCURRENCE <br />S4,000,000 <br />AGGREGATE <br />s4,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION$ <br />Is <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/N <br />ANY PROPRIETOR/PARTNERIEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />12WEAR6ZCZ <br />5/01/2 2 <br />05/01f202 <br />PER OTH- <br />E.L. EACH ACCIDENT <br />$1 000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />I $1-000,000 <br />C <br />Professional Liab <br />CSIE0022100 <br />10/31/2022 <br />10/31/202 <br />$3,000,000 Per Clm/Agg <br />D <br />Excess Prof <br />U5F00202222 <br />10/31/2022 <br />10/31/202 <br />$2,000,000 Per Clm/Agg <br />A <br />Pollution Liab <br />ENC000915201 <br />10/31/2022 <br />10/31/202 <br />$1M Per Occ/$2M Per Aqu <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Certificate holder is included as additional insured for general liability coverage as required by written <br />contract. A waiver of subrogation applies in favor of the additional insureds for general liability as <br />required by written contract. <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center PI ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />a^.:�, 1LdeMwgnled D'oiimt <br />' e%g/ REVIEWED&APPROVm BY; / <br />©1988.2015 ACORD C T4" JfI0oV1 <br />ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD Risk Management Analyst <br />#S5480745/M4369075 <br />