|
PROFE-9
<br />np in. MR
<br />D041171202YY)
<br />04117/2024
<br />CERTIFICATE OF LIABILITY INSURANCE
<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 f oltl n
<br />PRODUCER 949-855-U43
<br />SWELL INSUrANCE A NCY Aceved
<br />n��a�I�L��/al{I ¢' OA 1
<br />is i8C n 91 �evedo
<br />JO¢A. BOS Date: 20
<br />e O
<br />PNGNE 949-855A430 FAX 949582-2983
<br />NC No Ext: A/C No:
<br />E-MAIL MIC
<br />ell e O W Win urance.com
<br />N ROING COVERAGE NACp
<br />Insurance CO
<br />41297
<br />_ I IINSURERA:Scottsdale
<br />INSURPD
<br />Proprietary Access Control
<br />Enterprises Inc DBA
<br />Professional Access CCTV &
<br />Electical
<br />22845 Savi Ranch Pkwy Unit AS
<br />N RERB:CaliforniaAutomobileInsCo
<br />38342
<br />Oak River Insurance Company
<br />I RE c: P y
<br />RER .Houston Casualty Company
<br />INSURER E:Westcheater Surplus Lines Ins
<br />10172
<br />Yorba Linda, CA 92887
<br />Burlin ton Insurance Company
<br />INSURER F: 9 P Y
<br />COVERAGES CERTIFICATE NUMBER: RFVI.SInN NI IMRFR-
<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 />IITR NSR
<br />TYPE OF INSURANCE
<br />AOD
<br />SUB
<br />POLICYNUMBER
<br />POnnryVy
<br />POUCYEXP
<br />UNITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />X
<br />X
<br />CPS7890462
<br />11/0112023
<br />11/01/2024
<br />EACH OCCURRENCE
<br />1,000,000
<br />DAMAGE TO RENTED
<br />Me occurrence)
<br />50,00EREMISLS
<br />X
<br />MED EXP IAry.r. erson
<br />5,000
<br />Cross Liab Incl
<br />PER PROJ AGG INCL IF REQ
<br />X
<br />E&O; Contractual.
<br />PERSONAL & AOV INJURY
<br />1,000,000
<br />BY WRITTEN CONTRACT
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY FX] jPgT LOG
<br />GENERALAGGREGATE
<br />2,000,000
<br />PRODUCTS-COMP/OPAGG
<br />$ 2,000,000
<br />Deduct.
<br />$ None
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />ILA modan'
<br />$ 1,000,000
<br />BODILY INJURY Per amon
<br />3
<br />X
<br />ANY AUTO
<br />OWNED
<br />U OS ONLY )t AUUTOSSWULNED
<br />X
<br />X
<br />BA040000081291
<br />06/26/2023
<br />06/26/2024
<br />X
<br />BODILY INJURY Per accident
<br />$
<br />X
<br />PerOaCiR�nt AMAGE
<br />$
<br />AUTOS ONLY X AUTOS ONLY
<br />3
<br />F
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />S 5,000,000
<br />X
<br />N
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIM' -MADE
<br />773BE09109
<br />11/0112023
<br />11/01/2024
<br />DED RETENTION $ 0
<br />S
<br />C
<br />WORKERS COMPENSATION
<br />AND ROPRIFERIPARTILITY
<br />OFF1ANVPROPRIETOR/ ER EMUUDR/EXECUnVE ❑
<br />(Ms. story NH)
<br />(Mandatory in NHI
<br />If yes, aescnbe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />11
<br />PRWC438696
<br />11/01/2023
<br />11101/2024
<br />X I PERTUTE I OTH-
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE -EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />E
<br />Pollution Liab
<br />G28319101004
<br />11/30/2023
<br />11/30/2024
<br />Claim/Agg
<br />1,000,000
<br />D
<br />Cyber Liab
<br />H22NGP21211302
<br />12/0912023
<br />12109/2024
<br />Claim/Agg
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Certificate Holder, its officers, officials, employees, volunteers are
<br />included as Additional Insureds per GLS150s, CG2001, MCA85100817CA
<br />attached; Waiver of Subrogation included per CG2453, MCA85100817CA,
<br />WC990410C attached. 30 days notice of cancellation(10 days for non payment).
<br />Re: 26 Civic Center Plaza, Santa Ana CA / 122 N Newhope St, Santa Ana CA
<br />City of Santa Ana, its
<br />officers, officials, employees
<br />& volunteers
<br />20 Civic Center Plaza
<br />ACORD 25 (2016103)
<br />SANTA89
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF
<br />ACCORDANCE WITH THE POLICY PRO � RidtMvrganod IXNdon
<br />WAIMM
<br />`IffiMEwEofi APPROJ®BY:
<br />AUTHORIZED REPRESENTATIVE A�
<br />(( �i
<br />,45LtzbL)Ilw Risk Management Specialist
<br />© 1988-2015 ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />
|