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<br />TORTGAL-01WBATESON <br />DATE (MM/DD/YYYY) <br />CERTIFICATE OF LIABILITY INSURANCE <br />5/3/2024 <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 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 <br />NAME: <br />PHONEFAX <br />Ames & Gough <br />Ejhjubmmz!tjhofe!cz!Bohjf! <br />(703) 827-2277(703) 827-2279 <br />(A/C, No, Ext):(A/C, No): <br />8300 Greensboro Drive <br />E-MAIL <br />admin@amesgough.com <br />Suite 980 <br />ADDRESS: <br />Bdfwfep! <br />McLean, VA 22102 <br />Bohjf!Bdfwfep <br />INSURER(S) AFFORDING COVERAGENAIC # <br />Sentinel Insurance Company, LTD (XV) A+11000 <br />INSURER A : <br />Ebuf;!3135/16/17!24;61;57!.18(11( <br />INSURED <br />Hartford Insurance Company of the Southeast <br />38261 <br />INSURER B : <br />Torti Gallas and Partners, Inc. <br />Travelers Casualty & Surety Co. of America A++, XV <br />31194 <br />INSURER C : <br />1923 Vermont Avenue, NW <br />INSURER D : <br />Grimke School, 2nd Floor <br />Washington, DC 20001 <br />INSURER E : <br />INSURER F : <br />COVERAGESCERTIFICATE 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 />INSRADDLSUBRPOLICY EFFPOLICY EXP <br />TYPE OF INSURANCEPOLICY NUMBERLIMITS <br />LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) <br />2,000,000 <br />A <br />COMMERCIAL GENERAL LIABILITY <br />X <br />EACH OCCURRENCE$ <br />DAMAGE TO RENTED <br />1,000,000 <br />CLAIMS-MADEOCCUR <br />X <br />42SBWBI70305/1/20245/1/2025 <br />$ <br />PREMISES (Ea occurrence) <br />10,000 <br />MED EXP (Any one person)$ <br />2,000,000 <br />PERSONAL & ADV INJURY$ <br />4,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ <br />PRO- <br />4,000,000 <br />X <br />POLICYLOC <br />PRODUCTS - COMP/OP AGG$ <br />JECT <br />OTHER:$ <br />COMBINED SINGLE LIMIT <br />2,000,000 <br />A <br />AUTOMOBILE LIABILITY <br />$ <br />(Ea accident) <br />ANY AUTO 42SBWBI70305/1/20245/1/2025 <br />BODILY INJURY (Per person)$ <br />OWNEDSCHEDULED <br />AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ <br />PROPERTY DAMAGE <br />HIREDNON-OWNED <br />XX <br />(Per accident)$ <br />AUTOS ONLYAUTOS ONLY <br />$ <br />5,000,000 <br />A <br />XX <br />UMBRELLA LIABOCCUR <br />EACH OCCURRENCE$ <br />42SBWBI70305/1/20245/1/2025 <br />5,000,000 <br />EXCESS LIABCLAIMS-MADE <br />AGGREGATE$ <br />10,000 <br />X <br />DEDRETENTION$ <br />$ <br />PEROTH- <br />WORKERS COMPENSATION <br />B <br />X <br />STATUTEER <br />AND EMPLOYERS' LIABILITY <br />Y / N <br />42WEGAX2W5U5/1/20245/1/2025 <br />1,000,000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT$ <br />N / A <br />N <br />OFFICER/MEMBER EXCLUDED? <br />1,000,000 <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE$ <br />If yes, describe under <br />1,000,000 <br />DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ <br />Professional Liab.1078666737/1/20237/1/2024 <br />Per Claim/Aggregate4,000,000 <br />C <br />DESCRIPTION OF OPERATIONS / LOCATIONS / 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 />CERTIFICATE HOLDERCANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br /> <br />