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ENVIPLA-02 SUMMANR
<br />ACORO CERTIFICATE OF LIABILITY INSURANCE DATE 1
<br />6/12/212/2024
<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 HOLDF;,
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURE I, the of p}(g �ITI�I o isions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditi( is of ball I ci m a ment. A statement on
<br />this certificated not confer rights to tI* certificate holder in lief o_+ such endorsement(s).
<br />PRODUCER License 67 CONTACT m
<br />IOA Insurance S ngie
<br />P E FAX :C, No):
<br />3875 Hopyard R d
<br />Suite 200 ADMDRESS: Rita.Sumffan@ioausa.com
<br />Pleasanton, CA 94588 A
<br />ualty Com
<br />INSURED INs. "RB:Hartford Casualty Insurance Compart
<br />En Ent i pm e0d
<br />SnEol n '0 M--,4
<br />333 Mic Is :,%Lte 50 ° • • •
<br />Iry e, CA 6 INSURER E
<br />S R 77 1 in
<br />CnVFRAnFR CFRTIFICATF JIIN sFR- . In FR
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSJIF:.,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 />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY � JECT1:1 LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE 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 />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X 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 YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />NIA
<br />A
<br />X
<br />57WEGAC20BW
<br />9/30/2023
<br />9/30/2024
<br />PER OTH-
<br />X 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 1D1, Additional Remarks Schedule, may be 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 cANrFLLFD BEFORE
<br />THE EXPIRATION DATE THEREO
<br />ACCORDANCE WITH THE POLICY PR( HouN Risk MeagernentDivisIan
<br />REVIEWED & APPROVED BY:
<br />City of Santa Ana AUTHORIZED REPRESENTATIVE °I, ���,
<br />Risk Management Divison MR 4g�e
<br />44
<br />20 Civic Center Plaza, 4th Floor f• �� -� 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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