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Last modified
6/12/2024 2:36:33 PM
Creation date
8/22/2023 4:47:04 PM
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Template:
Contracts
Company Name
ASCENT ENVIRONMENTAL
Contract #
A-2020-241-02
Agency
Planning & Building
Council Approval Date
12/1/2020
Expiration Date
11/30/2023
Insurance Exp Date
3/15/2025
Destruction Year
2028
Notes
For Insurance Exp. Date see Notice of Compliance
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/YYYY) <br />CERTIFICATE OF LIABILITY INSURANCE DATE 3(MMIDD(MM/DD4 <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 d cogditio of the policy, je�jt—aln pRlicies rpay require an endorsement. A statement on <br />Athis certificat@ does not confer riahts to the certii catrikidr# (yabf�sl1E1I1Celidt(r3eih�ltif(I nn I P <br />AUc3 1 I"'" �p� `I, <br />A r sign Professionals Insurance S7`C�T� <br />3697 Mt. blo Blvd., Suite 230 <br />Lafayette CA 94549 Date. 202 <br />\cey o 16003745 <br />INSURED CEENV-01 <br />Ascent Environmental, Inc. <br />455 Capitol Mall Suite 300 <br />Sacramento CA 95814-4405 <br />nlHON v' Mandy Guo <br />PHONE <br />A/C No Ext: <br />510-272-1402 <br />E-MAIL <br />A R rt <br />. <br />INSURERA: <br />Travelers Property <br />INSURERB: <br />The Travelers Inde <br />INsuRERc: <br />Underwriters at Llo <br />INSURERD: <br />INSURER E : <br />uredPartners.com <br />RDING COVERAGE NAIC # <br />Casualty Company of America 25674 <br />mnity Company of Connecticut 25682 <br />vd's, London/AP Beazlev Svndica <br />COVERAGES CERTIFICATE NUMBER: 1798111270 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 <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICYNUMBER <br />POLICY EFF <br />MM/DD <br />POLICY EXP <br />MM/DD <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />68061-1400124 <br />3/15/2024 <br />3/15/2025 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />CLAIMS -MADE OCCUR <br />PREMISES DAMAGE TO <br />ccurrence <br />PREMISES Ea occurrence) <br />$ 1,000,000 <br />X <br />MED EXP (Any one person) <br />$ 10,000 <br />Contractual Liab <br />Included <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />POLICY � PECOT- LOC <br />PRODUCTS - COMP/OP AGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />Y <br />Y <br />BA4R770955 <br />3/15/2024 <br />3/15/2025 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />X <br />FIR ERTYDAMAGE <br />Per accident <br />$ <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />X <br />$ <br />NoOwned Auto <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />Y <br />UB7K512607 <br />3/15/2024 <br />3/15/2025 <br />X PER OTH- <br />STATUTE ER <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />OFFICER/MEMBER EXCLUDED? <br />N /A <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 />$ 1,000,000 <br />C <br />ProfessionalLiability <br />ENP000709003 <br />3/15/2024 <br />3/15/2025 <br />Per Claim <br />$2,000,000 <br />Aggregate Limit <br />$4,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />The Named Insured has no company owned autos. <br />Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies. <br />Project: City of Santa Ana — On -Call Environmental and Planning Services Related to CEQA and NEPA The City of Santa Ana, its officers, employees, agents, <br />volunteers and representatives are named as additional insureds as respects general liability as required per written contract. General Liability is <br />Primary/Non-Contributory per policy form wording. <br />CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PRC <br />The City of Santa Ana RiskManagmumtDMslcrn <br />20 Civic Center Plaza s%�F <br />Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE �, REVIEWED&PaPPROVmBY: <br />°7 A� <br />Risk Management Specialist <br />© 1988-2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />
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