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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DDNYYY)
<br />10/20/2023
<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(sl.
<br />PRODUCER
<br />AssuredPartners Design Professionals Insurance Services, LLC
<br />3697 Mt. Diablo Blvd Suite 230
<br />Lafayette CA 94549 A
<br />INSURED , ` 0
<br />MIG, Inc.
<br />Moore lacofano Goltsman, Inc.
<br />800 Hearst Ave
<br />Berkeley CA 94710
<br />COVERAGES
<br />REV.LSIQNM E :
<br />32603
<br />25674
<br />25682
<br />THIS IS TO CERTIFY HAT C IN T BEN fi D N S Ejj, A O R THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING Y REQUIREMENT, TE M Or? JNDITIO OF A N R DO T SPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSU'tff _E AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS ShG,VN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />LTR
<br />OF INSURANCE
<br />ADDLTYPE
<br />INSD
<br />BURR
<br />NUMBER
<br />POLICPOLICY
<br />MMIDD//YVFYY
<br />MMIDI)
<br />LIMITS
<br />C
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />6801H899998
<br />8/31/2023
<br />8/31/2024
<br />RRENCE
<br />$1.000,000
<br />CLAIMS -MADE OCCUR
<br />RENTED
<br />Ea occurrence
<br />$1,000,000
<br />X
<br />UPny one person)
<br />$10,000
<br />Contractual Lab
<br />Included
<br />AOV INJURY
<br />Mo
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERA -AGGREGATE
<br />$2,000,000
<br />POLICY JECT LOG
<br />-COMP/OP AGG
<br />$2,000,000
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />IIAOSI19941
<br />8/31/2023
<br />8/31/2024
<br />OMBBINEDtSINGLE LIMIT
<br />(E. cridlm
<br />$1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />CHAUTOS FOULED
<br />OWNED SC
<br />AUTOS ONLY
<br />BODILY INJURY (Per accident)accident)$
<br />X
<br />PROPERTY DAMAGE
<br />Per mcimmt
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />B
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CUPOH758762
<br />8/31/2023
<br />8/31/2024
<br />EACH OCCURRENCE
<br />$10,000,000
<br />AGGREGATE
<br />s10.000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X I RETENTION$ D
<br />$
<br />p
<br />COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />Y
<br />UB2L553909
<br />8/31/2023
<br />e/31/
<br />XPERTUTEWORKERS
<br />ORH-
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />ANYPROPRIETORIPARTNEWEXECUTIVE
<br />OFFICER/MEMBEREXCLUDED?
<br />NIA
<br />E.L. DISEASE -EA EMPLOYEE
<br />$1,OG0,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS be.
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />A
<br />Professional Liability a
<br />Conte Pollution Liab Included
<br />AEC9D7002005
<br />8/31/2023
<br />113112024
<br />Per Claim/5,000,000
<br />Included
<br />$5,000,000/Aggr
<br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule, may be attached if more space is required)
<br />Umbrella Liability policy is a follow -form to its underlying Policies: General Liability/Auto Liability/Employers Liability.
<br />RFP No #23-010. Project: California Environmental Quality Act (CEQA).
<br />City of Santa Ana, its officers, officials, employees, and volunteers are named as an additional insured as respects general liability and auto liability as required
<br />per written contract. General Liability is Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of subrogation per the attached
<br />endorsement(s).
<br />City of Santa Ana
<br />20 Civic Center Plaza (M-30)
<br />P.O. Box 1988
<br />Santa Ana CA 92702-1988
<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 />AUTHORI 0 REPRESENTATIVE
<br />©1988-2015 ACORD
<br />(,, ® Rv%MAPPRwr.REVIEwEgr���
<br />Rsk ManagementSpertaftif
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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