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AC V CERTIFICATE OF LIABILITY INSURANCE 7lT2/11/2024
<br /> (MM/DD/YYYY)
<br /> +%.�
<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 /> CONTACT
<br /> PRODUCER 858-229-1826 858-408-2901 NAME: Michael Santos Insurance Services
<br /> Michael Santos Insurance Services ONE
<br /> a/CC No,Ext: 858-229-1826 a,No: 858-408-2901
<br /> 5666 La Jolla Blvd E-MAIL SS: msantos@wcAccess.com
<br /> #303 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> La Jolla CA 92037-7523 INSURERA: Philadelphia Indemnity Ins Co 18058
<br /> INSURED (925) 718-3309 INSURERB:
<br /> Fastrack Solutions, Inc./TEC West INSURERC:
<br /> 9125 Archibald Ave Suite A INSURERD:
<br /> INSURER E:
<br /> Rancho Cucamonga, CA 91730 INSURERF:
<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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ EACH OCCURRENCE $ 1,000,000
<br /> A CLAIMS-MADE �✓ OCCUR PR EM SESOEa oNcurrDence $ 100,000
<br /> PHPK2582190-003 07/16/2024 07/16/2025 MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> ✓ POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: EBL $ 1,000,000
<br /> CBIA AUTOMOBILE LIABILITY ✓ ✓ PHPK2582190-003 07/16/2024 07/16/2025 Ea a.ideDtsINGLE LIMIT $ 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 /> ✓ UMBRELLALIAB ✓ OCCUR PHUB874536-003 07/16/2024 07/16/2025 EACH OCCURRENCE $ 5,000,000
<br /> A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000
<br /> DED RETENTION$ $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> ❑
<br /> OFFICER/MEMBER EXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Professional Liability E&O PHPK2582190-003 07/16/2024 07/16/2025 1,000,000/2,000,000 Deduct:$1,000
<br /> A Employment Practices Liability PHPK2582190-003 07/16/2024 07/16/2025 2,000,000/2,000,000 Retention:$25K
<br /> A I Crime PHPK2582190-003 07/16/2024 07/16/2025 $100,000 Deduct:$1,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The Entity,its officers,officials,employees,and volunteers are to be covered as additional insureds on the CGL policy with respect to liability
<br /> arising out of work or operations performed by or on behalf of the Contractor including materials,parts,or equipment furnished in connection with
<br /> such work or operations.
<br /> For any claims related to this contract,the Contractors insurance coverage shall be primary coverage per blanket endorsement.Contractor hereby grants to Entity a waiver of any right to subrogation which any insurer of said
<br /> Contractor may acquire against the
<br /> Entity by virtue of the payment of any loss under such insurance.
<br /> Contractor agrees to obtain any endorsement that may be necessary to affect APPROVED
<br /> this waiver of subrogation,but this provision applies regardless of whether or not the Entity has received a waiver of subrogation endorsement from
<br /> he insurer. By Cynthia Mora at 8;59 am, Dec 23, 2024
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City Of Santa Ana
<br /> Risk Management Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Santa Ana, CA 92702
<br /> AUTHORIZED REPRESENTATIVE
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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