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A� �® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMID2f3Yy) <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 />AssuredPartners Design Professionals Insurance Services, LLC <br />3697 Mt. Diablo Blvd Suite 230 <br />Lafayette CA 94549 <br />CONTACT <br />NAME: Lisa Shimizu-FookesPHONE <br />714427 3482 FAX <br />- we No): <br />Eooness: CerlsDesi nPro AssuredPartners.com <br />INSURERS AFFORDING COVERAGE <br />NAICk <br />INSURER A: XL Specialty Insurance Co, <br />37885 <br />Licenselli,6003745 <br />INSURED PSOMASM1 <br />PSOMAS <br />INSURER B : <br />865 S. Figueroa Street, Suite 3200 <br />INSURER C: <br />INSURER 0 : <br />Los Angeles CA 90017 <br />INSURER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 46060403 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 />TYPEOFINSURANCE <br />ADDLSUBR <br />POLICYNUMBER <br />POLICY EFF <br />MWDD/1'YYY <br />POLICY UP <br />MNVDDfYYYY1 <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 171 OCCUR <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />PREMISES F. occurrence <br />$ <br />MED UP (Any one percent <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />GENL <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ JECT LOG <br />GENERALAGGREGATE <br />$ <br />PRODUCTS -COMPIOP AGG <br />$ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY (Par person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURYPd <br />(Per accident) <br />( ) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per amident <br />$ <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />PER OTH- <br />AND EMPLOYERS' LIABILITY YIN <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />ANYPROPRIETORIPARTNEmEXECUTIVE ❑ <br />OFFICEWMEMBEREXCLUDED7 <br />NIA <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />A <br />Professional Uab&red, Liab <br />Y <br />DPR5018205 <br />10/15/2023 <br />10/15/2024 <br />Per Claim <br />$2,000,000 <br />Claims Made Form <br />Retro Date:1 W15/1947 <br />Aggregate Limit <br />$2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />Additional Insured Status is not available on Professional Liability Policy. <br />3SAN050099, On -Call Environmental Services - CEQA and NEPA. Client #RFQ No. 20-1 DO - <br />Insurance coverage includes waiver of subrogation per the attached endorsement(s). <br />30 Dav 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 />Attn: Risk Management Division RI&MmugelmedDhishm. <br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE REVIEWW ED&APPRB]BY: <br />Santa Ana CA 92702 I ^I o� .,k A+IpAaV406 <br />Risk Management Specialist <br />©1968-2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />