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�1 TORTGAL-01
<br />ABUYTENHUYS
<br />OATE(MMDDYVYY)
<br />11/28/2023
<br />CERTIFICATE OF I INSURM& signed
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AKD CONFERS 1'.0 Ri HTS 1)ON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT ED BY THE POLICIES
<br />BELOW. REPCERTIFICATE OF RESENTATIVE ERR PRODUCER, INSURANCE
<br />ND CERTIFICATE MOTH ( R09MVLY OR NEGATIVELY AMWD, E)CrEND 0——F(�IyVF�F�:3.. E�SQI/jtIJSaU RER( ), AUTHORIZED
<br />ILLFINSU�SREED
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL 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 />Ames & Gough
<br />8300 Greensboro Drive
<br />Suite 980
<br />CONT
<br />EACT
<br />PHONE
<br />(A/C, No, EAU: (703) 827-2277 ��, Np,(703) 827-2279
<br />nD`DAIEss: admin@amesgough.com
<br />McLean, VA 22102
<br />INSURERS AFFORDING COVERAGE
<br />NAIC e
<br />INSURER A: Sentinel Insurance Company, LTD XV A+
<br />11000
<br />INSURED
<br />INSURER B: NutmegInsurance Company
<br />39608
<br />Torti Gallas and Partners, Inc.
<br />1923 Vermont Avenue, NW
<br />Grimke School, 2nd Floor
<br />INSURER C : Hartford Insurance Company of the Southeast
<br />38261
<br />INSURER D :Travelers Casualty & Surety Co. of America A++, XV
<br />31194
<br />INSURER E:
<br />Washington, DC 20001
<br />NSURERF:
<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 CONTRACTOR 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 />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY UP_LTBL
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ❑X OCCUR
<br />42SBWBI7030
<br />5/1/2023
<br />51112024
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />DAMAGE TO RENTED
<br />EMISES Eacccurran
<br />$ 7000000
<br />MED EXP (Any oneperson)
<br />$ 15,000
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY [X] JERCOT LOC
<br />GENERALAGGREGATE
<br />$ 4,000,000
<br />GEN'L
<br />PRODUCTS - COMP/OP AGO
<br />$ 4,000,000
<br />OTHER'
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />EOMBINEDelseSINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY Perperson)
<br />$
<br />X
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />42UEGAF6689
<br />51112023
<br />51112024
<br />BODILY INJURY Per accident
<br />$
<br />Pe'acc EentA�GE
<br />$
<br />AlJRT030NLY ABTOSONt.�B
<br />A
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />42SBWBI7030
<br />5/1/2023
<br />5/112024
<br />AGGREGATE
<br />$ 5,000,000
<br />DED X RETENTION$ 10,000
<br />C
<br />WORKERS COMPENSATION
<br />ANYPROPRIETORIPARTNEWEXECUTIVE YIN
<br />pFFICERIMEMBW�,� EXCLUDED? �N
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N/A
<br />42WEGAX2W5U
<br />5/112023
<br />511/2024
<br />X STATUTE OAND TH-
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE- POLICY LIMB
<br />1,000,000
<br />D
<br />Professional Liab.
<br />107866673
<br />71112023
<br />711/2024
<br />Per Claim/Aggregate
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />The City of Santa Ana, its officers, officials, employees, and volunteers are Included as additional insured with respect to General Liability, Automobile
<br />Liability and Umbrella Liability when required by written contract. General Liability Includes Additional Insured coverage for On -Going & Completed
<br />Operations as required by written contract. General Liability, Automobile Liability, and Umbrella Liability are primary and non-contributory over any existing
<br />insurance and limited to liability arising out of the operations of the named insured and when required by written contract. General Liability, Automobile
<br />Liability, Workers Compensation and Umbrella Liability policies include a waiver of subrogation in favor of the additional insureds where permissible by state
<br />law and when required by written contract. Umbrella Liability coverage sits excess over General Liability, Automobile Liability and Employers Liability
<br />coverage. 30-day Notice of Cancellation will be Issued for the General Liability, Automobile, Workers Compensation, Umbrella, and Professional Liability
<br />coverage in accordance with policy terms and conditions. Umbrella Liability coverage follows form.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<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
<br />REPRESENTATIVE
<br />" V d
<br />ACORD 25 (2016103) @ 1988-2015 ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />RideMnugemoltOtdalan
<br />REVIEWED 6 APPRwED BY:
<br />A4V' Aa"4
<br />`.
<br />-
<br />Risk Management Specials[
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