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RICHWAT-03 ELEM
<br /> ,4coRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 9/26/2024
<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 CONTACT Martha De La Torre
<br /> NAME:
<br /> Acrisure Southwest Partners Insurance Services, LLC PHONE FAX
<br /> 4000 Westerly Place (A/C,No,Ext):(818)808-1049 (A/C,No):
<br /> Suite 110 E-MAIL
<br /> MDelatorre@acrisure.com
<br /> Newport Beach,CA 92660
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Vigilant Insurance Company 20397
<br /> INSURED INSURER B:Federal Insurance Company 20281
<br /> Richards,Watson&Gershon INSURER C:
<br /> 350 South Grand Ave.,37th Floor INSURER D
<br /> Los Angeles,CA 90071-3101
<br /> INSURER E
<br /> 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 NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM/DD/YYYY MM/DD/YYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR 35293250 10/1/2024 10/1/2025 DAMAGE TO RENTED 1,000,000
<br /> X PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY PRO- Included
<br /> JECTPRO- X LOC PRODUCTS-COMP/OP AGG $
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> ANY AUTO 74967929 10/1/2024 10/1/2025 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED )( NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 9,000,000
<br /> EXCESS LIAB CLAIMS-MADE 79611586 10/1/2024 10/1/2025 AGGREGATE $ 9,000,000
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> 71726476 10/1/2024 10/1/2025 E.L.EACH ACCIDEN 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ T $
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 1D1,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana,its employees,officers and agents are named as an Additional Insured as required by written contract per Endorsement Form#80-02-2367
<br /> attached. Coverage subject to policy terms,conditions and exclusions. 30 day notice of cancellation applies to the certificate holder in event of cancellation
<br /> except for non-payment of premium is 10 days.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> Laura Rossini,Acting Chief Assistant City Attorney
<br /> 20 Civic Center Plaza,4th floor AUTHORIZED REPRESENTATIVE
<br /> Santa Ana,CA 92701
<br /> ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD APPROVED
<br /> By Cynthia Mora at 7:47 am,Oct 30,2024
<br />
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