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E '4`0��.'0® CERTIFICATE OF LIABILITY INSURANCE DAT$/29/2024YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). (PRODUCER CON IACI NAME: . Western Republic Insurance Services PHONE No,Eit: 714.536.0500 • FAX No): 19900 Beach Blvd S A" 144:iiatf ustgn e d by Suite Fl n g INS ER(S)AF DING COVERAGE NAIL# Iluntington Beach I CA 92648 SURER A:.BE Y ASSURANCE C 39462 INSURED Artlg ie eiedo J&L Constructors Inc INSURER C: STATE COMPENSATION INS 35076 29104 Basswood , SUt 'e• I 4.0 6. 1 0 Lake Elsinore N COVERAGES R ICA U 7706.06 _U 7 4 A NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIST,IP BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUULbUBK POLICY EFF--POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER JMMIDD/YYYY) MMIDDIYYYY) LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 UAMAUE I U KEN I ED CLAIMS-MADE 7OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y Y VUMA0310931 04/27/2024 04/27i2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 KPOLICY n JECT n LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMI I $ _ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ —OWNED —SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED —NON-OWNED PROPER!Y DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB K OCCUR EACH OCCURRENCE $ 5,000,000 B x EXCESS LIAB CLAIMS-MADE EZXS3156475 05/02/2024 04/27/2025 AGGREGATE $ 5,000,000 DED RETENTIONS $ WORKERS COMPENSATION PER O1H- AND EMPLOYERS'LIABILITY YIN STATUTE ER - CANY PROPRIETOR/PARTNER/EXECUTIVE PRIETOOFFICER/MEMBERTR/E NIA ECUTIVE E.L.EACH ACCIDENT $ 1,000,000 EXCLUDED? Y 9170623-23 12/03/2023 12/03/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the insured's operations.The certificate is named as additional insured per the attached CG 20 10 12 19.Waiver of subrogation applies per the CG 24 04 12 19.Insurance is primary and noncontributory per the attached VCAS2035 11 10. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PRC\ RiekMaragenunEDlvislan ;i u Risk Management Division AUTHORIZED REPRESENTATIVE ` . 1. REVIEWED&APPROVED BY: 20 Civic Center Plaza,4th Floor D«y1i,.�Kcency 1 W11�� /14.p AtCyan 1 Santa Ana,CA 92701 Risk Management Specialist ©1988-2015 ACORI/ _ ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD