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AC"R" CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />05/13/2024 <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 />PRODUCER <br />NTACT Kasey Litz <br />ME: <br />Stanton and Associates Inc. <br />ONN Ext : (805) 413-1498 FAX <br />No): (805) 435-3737 <br />TA <br />ISU Stanton & Associates <br />AIL a ne isustanton.com <br />ADDRESS. y <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />3625 Thousand Oaks Blvd Suite 292 <br />Westlake Village CA 91362 <br />INSURER A : Crum & Forster,A(XIII) - CRC <br />44520 <br />INSURED <br />INSURER B : California Automobile - Mercury,A(XIV) <br />38342 <br />Envicom Corporation <br />INSURER C : Employers Compensation,A-(XI) <br />11512 <br />4165 Thousand Oaks Blvd Ste 290 <br />INSURER D : <br />INSURER E : <br />Westlake Village CA 91362 <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 2024-2025 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 />ADDLSUBR <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY) <br />LIMITS <br />X1 <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 2,000,000 <br />CLAIMS -MADE Fx_]OCCUR <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />100,000 <br />$ <br />X <br />MED EXP (Any one person) <br />$ 5,000 <br />Deductible: $5,000 per Occ <br />PERSONAL &ADV INJURY <br />$ 2,000,000 <br />A <br />Y <br />EPK-147858 <br />05/17/2024 <br />05/17/2025 <br />GEN'LAGGREGATE <br />LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />X <br />POLICY F-]JECT PRO- F-] LOC <br />PRODUCTS - COMP/OPAGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />B <br />OWNED X SCHEDULED <br />AUTOS ONLY /� AUTOS <br />BA040000085701 <br />12/05/2024 <br />12/05/2025 <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 />Hired/borrowed <br />$ Included <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ -------------- <br />AGGREGATE <br />$-------------- <br />EXCESS LIAB <br />CLAIMS -MADE <br />------------------------- <br />DED I I RETENTION $ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />N /A <br />EIG4690451-03 <br />02/04/2024 <br />02/04/2025 <br />PER I STATUTE 1OERTH- <br />X1 <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <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 />ADED: <br />PROFESSIONAL LIABILITY (E&O) <br />$5,000 PER CLAIM <br />EPK-147858 <br />05/17/2024 <br />05/17/2025 <br />POLICY AGGREGATE <br />3,000,000 <br />EACH CLAIM <br />3,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Project: RFQual 23-142 Environmental & Planning Services <br />The City of Santa Ana, its officers, officials, employees, and volunteers named as Additional Insured(s) <br />APPROVED <br />By Cynthia Mora at 10:31 am, Dec 13, 2024 <br />CERTIFICATE HOLDER 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 Risk Management Division <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 <br />LZ _. <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />