Laserfiche WebLink
AcoR©> CERTIFICATE OF LIABILITY INSURANCE DATE(MMYDDYYYYY) <br /> 03/31/2025 <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 CONTACT <br /> NAME: <br /> HONE Paragon Commercial Insurance Brokers arc No Ext: (415)971-9111 Fare No: (415)358-9410 <br /> One Sansome Street Suite 3500 ADDRESS:E-MAIL C� 9 p•commercialrisk rou info com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> San Francisco CA 94104 INSURERA: Travelers Insurance Company 38130 <br /> INSURED INSURERB: Travelers Insurance Company 38130 <br /> DKF Solutions Group. LLC INSURERC: RLI Insurance Company 13056 <br /> 170 Dogwood Lane INSURERD: <br /> INSURER E: <br /> Vallejo CA 94591 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MMYDDIYYYY MMYDDIYYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> — AMAGETO RENTED <br /> CLAIMS-MADE X OCCUR D PREMISES Ea occurrence $ 300,000 <br /> MED EXP(Anyone person) $ 5,000 <br /> A Y 680-8X765120-25-42 03/19/2025 03/19/2026 PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X POLICY PRO <br /> JEOT LOC PRODUCTS-COMPIOPAGG $ 4,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> A AUTO OWNES ONLY AUTOS D SCHEDULED 680-8X765120-25-42 03/19/2025 03/19/2026 BODILY INJURY(Per accident) $ <br /> X HIRED X I NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Peraccident <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 <br /> B EXCESS LIAB CLAIMS-MADE CUP-8X765943-25-42 03/19/2025 03/19/2026 AGGREGATE $ 1,000,000 <br /> X DED RETENTION 10,000 $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y r N STATUTE ER <br /> ANY PROPRIETORIPARTNERIEXEOUTIVE ❑ NIA E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBEREXCLUDED? <br /> (MandatoryinNH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Professional Liability Aggregate $2,000,000 <br /> C RTP0046370 03/19/2025 03/19/2026 Occurrence $2,000,000 <br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Tu Tran Tu Trally signed by <br /> Tu Tran Nguyen <br /> Date:2025.05.12 <br /> Nguyen 09:23:40-07'00' <br /> APPROVED <br /> By Tu Tran Nguyen at 9:23 am,May 12,2025 <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 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ATTN:Water Resources <br /> 215 S.Center St. AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92703 <br /> FBX_ Email O 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />