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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDD/YYYY)
<br />5/3/2024
<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 />McGriff Insurance Services LLC D I ry I
<br />2200 N. Commerce Parkway y
<br />Suite 200
<br />Weston FL 6 V% ♦m I r1 I.. - A
<br />INSURED 132SAFf
<br />Interwest Consulting Group, c. A
<br />444 N Cleveland Ave; A
<br />Loveland COAW538
<br />ACP \/P Nn Dat 1943n & uanc37532
<br />COVERAGES GER Pir :1951788570
<br />REVISION NUMBER -
<br />THIS IS TO CERTIFY THAT THE POLICIES OF AS) RANCE LISTS B BE I U I U D NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQ',IRF dENT, TERM OR FI ONT R DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PLR:AIN, 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 />INSIR LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMIDDIYYYYJ
<br />POLICY EXP
<br />fMNVDDfYYY`n
<br />LIMITS
<br />B
<br />X
<br />COMMERCIALGENERALUABILITY
<br />CLAIMS -MADE 1 I OCCUR
<br />Y
<br />Y
<br />CF3GL00415231
<br />10/3/2023
<br />10/3/2024
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMA ETO RENTED
<br />PREMISES Eaaccunence
<br />$300,000
<br />X
<br />MED EXP (Any r one Person)
<br />$10,000
<br />10,000
<br />PERSONAL& ADV INJURY
<br />$1.000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />PRO-JECT LOC
<br />POLICY 0
<br />GENERALAGGREGATE
<br />$2, 000, 000
<br />GEN'L
<br />X
<br />PRODUCTS-COMP/OPAGG
<br />$2,0DD,000
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />OMOBILE LIABILITY
<br />Y
<br />Y
<br />CF3CAD0337231
<br />10/3/2023
<br />10/3/2024
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />§1,000,000
<br />BODILY INJURY(Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULEDAUTOS ONLY AUTOS(eBODILY
<br />PX
<br />INJURY P raccitlent
<br />$
<br />HIRED X NON -OWNED
<br />ONLY AUTOS ONLY
<br />PROPERTYDAMAGE
<br />Per accident
<br />$
<br />Excess per occ/egg
<br />$1,000,000
<br />D
<br />UMBRELLALIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />Y
<br />Y
<br />BEA7XL000207902
<br />011170903
<br />10/3/2023
<br />10/3/2023
<br />10/3/2024
<br />10/3/2024
<br />EACH OCCURRENCE
<br />$10.0130,000
<br />X
<br />AGGREGATE
<br />$10,000,000
<br />DED X RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />V
<br />SAWC561586
<br />5/12/2024
<br />5/12/2025
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />ANYPROPRIETORIPARTNERIEXECUTIVE ❑
<br />OFFICER/MEMSEREXCLUDEDr
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory In NH)
<br />If yes, deacribe under
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000.000
<br />DESCRIPTION OF OPERATIONS below
<br />F
<br />Professional Liability
<br />TER5070488
<br />10/3/2023
<br />10/3/2024
<br />Each Claim/Aggregate
<br />10,000,000
<br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Crime Coverage - TWO City Fire Insumnce Co NAIC #29459 - Policy #21 KB029389123 - Effective 1013/23 - 10/3124 - $1,000,000 Dead $10.000
<br />Cyber Coverage - Coalition Insurance Company NAIC # 29530 - Policy #C4LRS025767CYBER2023 effective 10/3123 - 10/3/24. AGG $3,000,000 DED
<br />$100,000.
<br />RE: RFQ 23-142 - On Call Environmental and Planning Services.
<br />The City of Santa Ana, its officers, officials, employees, and volunteers are additional insureds with respects to general and automobile liability, with a written
<br />contract. Waiver of Subrogation applies to general and automobile liability and workers compensation in favor of the additional insureds, with a written contract.
<br />Coverage is primary and non-contributory for the additional insureds. Notice of Cancellation is 30 days, except 10 days for non-payment.
<br />CERTIFICATE
<br />City of Santa Ana;Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PRC
<br />AUTHORIZED REPRESENTATIVE
<br />ULL v
<br />©1988-2015 ACORD
<br />RiekMWAgemadDleidmt
<br />REVIEWED&APPROVEDBY:
<br />`® AIV AaN44
<br />® Risk Management Specialist
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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