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_,.."" CHAMGRO-01 RENAS
<br /> 4�RLY CERTIFICATE OF LIABILITY INSURANCE DAT/15/2DWYYY)
<br /> 5/1 512 0 24
<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 License#0M10410 Nrdl�TEACT
<br /> Armstrong1Robitaille/Riegle Business and Insurance Solutions (A/C,No,Ext:j949)381-7700 I FAX
<br /> No):(949)861-9429
<br /> 1500 Quail St,Suite#100 p�L
<br /> Newport Beach,CA 92660 ADDRESS a r nf:(palera,r•u mAngie �' .,ns ��r �M. ,i�• NAIC#
<br /> INSURERA I'�utilus Insurance Company 17370
<br /> INSURED INSURERB t 1,, n a $5
<br /> Chambers Group Inc. INSURER ni'J e 0 t �� V��27847
<br /> 3151 Airway Ave, F208 INSURER I'Cost
<br /> Costa Mesa,CA 92626 . IF./I�afl • IfST-I�
<br /> ' REF' •,,
<br /> R
<br /> COVERAGES C M- 4:E- Ira • • • ` ON a Tr, a • Y
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWI-IJE BEEN ISSUE+ W. - R a ,,- ED .• E ?. E POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDIT*$ 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 NUMBER POLICY EFF POLICY EXP
<br /> LTRINSD WVD IMM/DDM'YY1 IMM/DDWYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR X X ECP2026303-16 5/12/2024 5/12/2025 R EMIBES(EaoCOUrDnce) $ 100,000
<br /> MED EXP(Any one person) $ 10,000
<br /> PERSONAL S.ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY X JECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000
<br /> OTHER: _ $
<br /> B AUTOMOBILE LIABILITY (Ea acccidentSINOI. LIMIT $ 1000Ggg
<br /> X ANY AUTO X X BAP2037737.12 5/12/2024 5/12/2025 Booty INJURY(Per person) $
<br /> AAUgTOS ONLY SCHEDULED
<br /> SSWDLEED pBODILY INJURYp (Per accident) $
<br /> X AUTOS ONLY X Mee llerraccident)AMAGE $
<br /> $
<br /> A UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 10,000,000
<br /> X EXCESSLIAB CLAIMS-MADE FFX2026322-16 5/12/2024 5/12/2025 AGGREGATE $ 10,000,000
<br /> DED RETENTIONS $
<br /> C AND EMPLOYERS COMPENSATION
<br /> X PER STATUTE ERH
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVEY/N X WSD 505523304 5/12/2024 5/12/2025 1,000,000
<br /> A�FFFILEWWMEEMBERq EXCLUDED? NIA E.L.EACH ACCIDENT $
<br /> (MandatoryIn NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 7,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Pollution Liability ECP2026303-16 5/12/2024 5/12/2025 Limit 1,000,000
<br /> A Professional Liab. ECP2026303-16 5/12/2024 5/12/2025 Limit 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
<br /> Re:On-Call Environmental Review Services-for Housing Division
<br /> City of Santa Ana,Its City Council,its officers,officials,employees,agents,and volunteers are included as additional insureds for General Liability,
<br /> Professional Liability,and Automobile Liability policies,with respect to any liability arising out of work or operations performed by or on behalf of the
<br /> Instructor including materials,parts,equipment,and personnel furnished in connection with such work or operations per the attached forms. Waiver of
<br /> Subrogation applies to General Liability,Professional Liability,and Automobile Liability policies per the attached forms. Primary and Non-Contributory
<br /> coverage applies to General Liability,Professional Liability,and Automobile Liability policies per the attached forms. 30 Day notice of cancellation applies
<br /> with the exception of 10 days for non-payment of premium per the attached forms.$25,000 SIR applies to the Professional Liability coverage. Professional
<br /> Liability Aggregate:$2,000,000.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED BEFORE ,I
<br /> City of Santa Ana THE EXPIRATION DATE THEREO allnliMr
<br /> ACCORDANCE WITH THE POLICY PR(
<br /> Attn:Executive Director,Community Development Agency «- � ManBB`Y^e�)t ci
<br /> d°IO11
<br /> 20 Civic Center Plaza M-25,P.O.Box 1988, i1A( i REVIEWED&APPROVED BY: r.
<br /> Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE ) ti.9. Add
<br /> ( Rkh Management Speciah%t
<br /> I
<br /> ACORD 25(2016/03) ©1988.2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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