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ENVIPLA-02 SUMMANR
<br />,d►coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br />6/12/2024
<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 HOLDFP
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURE I, the of t( IT o isions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditit is of pawl I I m a ment. A statement on
<br />this certificated not confer rights to tl* certificate holder in Iiel. of such endorsement(s).
<br />PRODUCER License 67 CONTACT rn
<br />IOA Insurance S n I P FAX
<br />3875 Hopyard R d E : ) (A/c, No):
<br />Suite 200 ADDRESS: Rita.Sum7ffan@ioausa.com
<br />Pleasanton, CA 94588 A
<br />INSURED
<br />En vir en i pm e0c
<br />Sol n
<br />333 Mic Is Dr., ite 50
<br />Iry e, CA 6
<br />rnVFRA(,FC CERTIFICATE JIIIV J=P-
<br />Hartford Casualtv Insurance
<br />0 r,x.-I
<br />INSURER E :
<br />MMMEWAM
<br />^ ^ 1
<br />20443
<br />29424
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INS F!.,NCE 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 />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE X OCCUR
<br />x
<br />X
<br />B6025654530
<br />6/23/2024
<br />6/23/2025
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />1,000,000
<br />$
<br />MED EXP (Any oneperson)
<br />$ 10,000
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GENT
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY X 71 PEt° LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />1,000,000
<br />$
<br />BODILY INJURY Perperson)
<br />$
<br />ANY AUTO
<br />X
<br />X
<br />B6025654530
<br />6/23/2024
<br />6/23/2025
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accident
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />A
<br />X
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />EXCESS LIAB
<br />X
<br />CLAIMS -MADE
<br />X
<br />X
<br />B6025663132
<br />6/23/2024
<br />6/23/2025
<br />AGGREGATE
<br />$ 4,000,000
<br />DED x RETENTION $ 10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/ R/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />EXCLU
<br />(Mandatory in NH)
<br />N / A
<br />X
<br />57WEGAC20BW
<br />9/30/2023
<br />9/30/2024
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />A
<br />Professional Liab.
<br />X
<br />EEH591923312
<br />9/30/2023
<br />9/30/2024
<br />Per Claim
<br />2,000,000
<br />A
<br />Professional Liab.
<br />X
<br />EEH591923312
<br />9/30/2023
<br />9/30/2024
<br />Aggregate
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana is included as additional insured on Commercial General Liability and Hired and Non -Owned Auto Liability, as required by written contract.
<br />Waiver of Subrogation and Primary and Non -Contributory Provision included on Commercial General Liability Policy, as required by written contract. Waiver
<br />of Subrogation Provision included on Workers Compensation policy, as required by written contract..Commercial Excess Liability policy follows form with the
<br />Commercial General Liability, Hired and Non -Owned Auto Liability and Employers Liability Policies. and Employers Liability Policies. Should any of the above
<br />described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. Professional Liability is a
<br />claims made policy and includes Waiver of Subrogation Provision as required by written contract.
<br />30-Day Notice of Cancellation is included per policy provisions.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREO
<br />ACCORDANCE WITH THE POLICY PRG RA Mougmumt DMsIan
<br />z, REVIEWED�y& APPROVED BY:
<br />City of Santa Ana AUTHORIZED REPRESENTATIVE °�1_If�d,a_I_�YCL' /"I'3 ' / CZV44
<br />Risk Management Divison ff"N-Aw MR
<br />20 Civic Center Plaza, 4th Floor �..�` m,J Risk Management Specialist
<br />Santa Ana CA 92701
<br />ACORD 25 (2016/03) © 1988-2015 ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />
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