|
74/21/2025
<br /> E(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE
<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 endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME: Shery YDun
<br /> Risk Strategies Company PHONE FAX
<br /> 2040 Main Street, Suite 450 A/C No Ext: 949-242-9237 (A/C,No
<br /> Irvine, CA 92614 ADDRESS: syoung@risk-strategies.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> www.risk-strategies.com CA DOI License No.OF06675 INSURERA: Travelers Property Casualty Cc of America 25674
<br /> INSURED INSURERB: Hartford Casualty Insurance Company 29424
<br /> IDS Group Inc. INSURERC: Arch Insurance Company 11150
<br /> 1 Peters Canyon Rd., Ste 130
<br /> Irvine CA 92606 INSURERD:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 84898472 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> A �/ COMMERCIAL GENERAL LIABILITY �/ �/ 6809H717919 5/1/2025 5/1/2026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE � OCCUR PREM SESOEa oNTE cur ance $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY ✓� JECT LOC PRODUCTS-COMP/OPAGG $4,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY BA7R248947 5/1/2025 5/1/2026 COMBINED SINGLE LIMIT $
<br /> Ea accident 1,000,000
<br /> ✓ ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident
<br /> A �/ UMBRELLALIAB f OCCUR CUP71<299343 5/1/2025 5/1/2026 EACH OCCURRENCE $9,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $9,000,000
<br /> DED ✓ RETENTION$0 $
<br /> B WORKERS COMPENSATION ✓ 72WEGAX2CTE 5/1/2025 5/1/2026 ,/ SPER TATUTE EORH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑ NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1 000 000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> C Professional Liability PAAEP0162701 11/12/2024 11/12/2025 Per Claim: $3,000,000
<br /> Aggregate: $3,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Digitally signed
<br /> Projects as on file with the insured including but not limited to RFP 23-025,On-Call Engineering Services. Tu Tran byTuTran
<br /> 1 9 g 9 Nguyen
<br /> City of Santa Ana,its officers,employees,agents,volunteers and representatives and primary/non-contributory clause applies to the Nguyen Date:2025.04.29
<br /> general and auto liability policies and a waiver of subrogation applies to the general,auto and work comp policies. 14:28:56-07'00
<br /> 30-day notice for non-renewal and cancellation, 10-day notice for non-payment of premium applies.
<br /> Professional Liability Retro Date:Full Prior Acts;Deductible$35,000 per claim.
<br /> APPROVED
<br /> By Tu Tran Nguyen at 2:28 pm,Apr 29,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> P.O. Box 1988 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza (M-30)
<br /> Santa Ana CA 92702-1988
<br /> AUTHORIZED REPRESENTATIVE
<br /> RSC Insurance Brokerage
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> 84898472 1 25-26 GL-AL-OL-WC, 24-25 PL I Sherry Young 1 4/21/2025 9:30:37 AM (PDT) I Psge 1 of 9
<br />
|