Laserfiche WebLink
ACOR" CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DDmYY) <br />11/29/2023 <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 ce-tif' axe hold r in liep of s c4 qndorUment(s). <br />r� aaif esign Professionals Insurance Services, LC <br />36 D7 �11toBIV .1 Suite 230 Aceve 0 <br />Lafayette CA 94549 <br />Date. 2024.0 <br />a UlrreFAX <br />PHONE <br />A/c No EXt : 510-272-1403 (A/C, No <br />E-MAIL <br />ADDRESS: CertsDesi nPro@AssuredPartners.com <br />ER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURERA: XL Speciality Insurance Company <br />37885 <br />yedo_ I se#: 6003745 <br />INSURED — ARCHRES-04 <br />INSURER B: The Travelers Indemnity Company of Connecticut <br />25682 <br />Architectural Resources Group, Inc. <br />Pier 9, The Embarcadero, Suite 107 <br />INSURERC: HARTFORD INSURANCE COMPANY <br />38288 <br />INSURERD: <br />San Francisco CA 94111 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 1093765710 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 />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />6802H186591 <br />9/1/2023 <br />9/1/2024 <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE OCCUR <br />PREMISES DAMAGE TO <br />PREMISES Ea occurrence) <br />ccurrence <br />$ 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 />BA1S985277 <br />9/1/2023 <br />9/1/2024 <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 />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />Y <br />57WEGLP7625 <br />9/1/2023 <br />9/1/2024 <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 />A <br />ProfessionalLiability & <br />DPR5017487 <br />9/1/2023 <br />9/1/2024 <br />Per Claim/$2,000,000 <br />$2,000,000/Agglmt <br />Contractors Pollution Legal <br />Included <br />Liability <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies. <br />Re: RFQ 23-142. <br />City of Santa Ana is named as an additional insured as respects general liability as required per written contract. General Liability is Primary/Non-Contributory <br />per policy form wording. Insurance coverage includes waiver of subrogation per the attached endorsement(s). <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 />City of Santa Ana ACCORDANCE WITH THE POLICY PRC <br />Risk Management Division RAManagmumtDMsian <br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE REVIEWED & APPROVED BY. <br />Santa Ana CA 92701 z C A A�44 <br />( .. <br />Risk Management Specialist <br />© 1988-2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />