|
�►�oRo� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMlDDIYYYY)
<br />3/25/2025
<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 endorsements .
<br />PRODUCER
<br />CONTACT
<br />NAME:
<br />PHONEWGNo. ExII: (760)770-2827 zi No:
<br />INSURANCE SUPER STORE,NET
<br />72-877 Dinah Shore Dr Ste 103
<br />-MAIL bill lnsurancesu erstore,net
<br />ADDRESSh
<br />INSURERS AFFORDING COVERAGE NAIL #
<br />Rancho Mirage, CA 92270
<br />INSURER A : CFC 5241
<br />OD28797
<br />INSURED
<br />INSURER B ; Employers Compensation Ins. Co 10346
<br />INSURER C :
<br />CV STRATEGIES, INC.
<br />INSURER D :
<br />73-700 Dinah Shore Unit 402
<br />-- —__._-------------__-._-
<br />INSURERE:
<br />PALM DESERT, CA 92211
<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 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 />INST R
<br />TYPE OF INSURANCE
<br />ADDL
<br />INgn
<br />wyn SUER
<br />POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />�
<br />� EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES E occurrenC
<br />$ 50,000
<br />-MADE � •
<br />MED EXP IAny one person
<br />$ 5,000
<br />PERSONAL a ADV INJURY
<br />$ 4,000,000
<br />A
<br />Y
<br />. Y
<br />ESN0240068513 9124/2024 9/24/2025
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />hGEN'L
<br />POLICY EC ❑ LOC
<br />$ 4,000,000
<br />PRODUCTS - COMPIOPAGG
<br />$
<br />OTHER:
<br />AUTOMOBILE LIABILITY
<br />COMBINEDaccident)SINGLE LIMIT
<br />fEa $ 4,000,000
<br />x ANY AUTO
<br />BODILY INJURY (Per person) $
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Pid$
<br />ESN0240068513 9/2612024 9/2612025 (Per accident) )
<br />HIRED NON -OWNED
<br />PROPERTY DAMAGE
<br />Ldentl $
<br />AUTOS ONLY AUTOS ONLY
<br />(Per
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />$
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />AGGREGATE
<br />DED RETENTION S
<br />$
<br />WORNMRS COMPENSATION
<br />IPFR OTH-
<br />AND EMPLOYERS' LIABILITY YIN
<br />STAT T ER
<br />E,L,EACHACCIDENT : $ 1,000,000
<br />8
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERfMEMBEREXCLUDED?
<br />NIA
<br />Y
<br />EIG471970804
<br />3/512025
<br />3/512026
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br />tMandalwy In NH)
<br />If yyes, describe under
<br />------ - _ --
<br />BESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $
<br />Occurrence 2,000,000
<br />A
<br />Professional E & O
<br />ESN0240068513
<br />8l2612024
<br />9J21312025
<br />Aggregate 2,000,000
<br />Cyber Liability
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached H more space Is required)
<br />Project Name: On -Call Public Relations Outreach Services Strategic Communications Support
<br />The District, its directors officers, employees, agents ,and Volunteers are named as additional insured on the Certificate of Insurance for
<br />general liability. Digitally signed
<br />Tu Tran by uy
<br />Nguyenn ROVED
<br />NN
<br />U enDate: 2025.04.02g Y F�7
<br />iz:4za7-o7oo Tran Nguyen at 12:41 pm, Apr 02, 2025
<br />City of Santa Ana
<br />PWA Water Resources
<br />215 S. Center Street
<br />Santa Ana, Ca. 92703
<br />I IUN
<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 PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />0 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
|