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ENVIPLA-02 SUMMANR
<br /> ACORO CERTIFICATE OF LIABILITY INSURANCE DATE 1
<br /> 6/12/212/2024
<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 HOLDF;,
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURE I,the of p}(g �ITI�I o isions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditi( is of ball I ci m a ment. A statement on
<br /> this certificated not confer rights to tI*certificate holder in lief o_+ such endorsement(s).
<br /> PRODUCER License 67 CONTACT m
<br /> IOA Insurance S gie
<br /> ,E FAX
<br /> P : C,No):
<br /> 3875 Hopyard R d
<br /> Suite 200 AfL
<br /> ADDRESS:Rita.Sumffan@ioausa.com
<br /> Pleasanton,CA 94588
<br /> U FORDING COVERAGE NAIC#
<br /> LRUMfOU kAualtycompany 20443
<br /> INSURED INs. -=RB:Hartford Casualty Insurance Company 29424
<br /> En en i pm ed
<br /> Sol n 0 M--%4 A-7 A 0
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<br /> Iry 2,CA 6 INSURER E
<br /> S R T
<br /> COVERAGES CERTIFICATE JUDPsER: I I . I J• IO ER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSJIF:.,NCE 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 $ 2,000,000
<br /> CLAIMS-MADE X 71 OCCUR B6025654530 6/23/2024 6/23/2025 DAMAGE TO RENTED 1,000,000
<br /> X X PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ 10,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY� JECT1:1 LOC PRODUCTS-COMP/OP AGG $ 4,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> ANY AUTO X X B6025654530 6/23/2024 6/23/2025 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> A X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000
<br /> EXCESS LIAB X CLAIMS-MADE X X B6025663132 6/23/2024 6/23/2025 AGGREGATE $ 4,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> PER OTH-
<br /> B WORKERS COMPENSATION X STATUTE ER
<br /> AND EMPLOYERS'LIABILITY YIN 57WEGAC20BW 9/30/2023 9/30/2024 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE NIA
<br /> A X E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED?
<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 /> A Professional Liab. X EEH591923312 9/30/2023 9/30/2024 Per Claim 2,000,000
<br /> A Professional Liab. X EEH591923312 9/30/2023 9/30/2024 Aggregate 4,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 1D1,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana is included as additional insured on Commercial General Liability and Hired and Non-Owned Auto Liability,as required by written contract.
<br /> Waiver of Subrogation and Primary and Non-Contributory Provision included on Commercial General Liability Policy,as required by written contract.Waiver
<br /> of Subrogation Provision included on Workers Compensation policy,as required by written contract..Commercial Excess Liability policy follows form with the
<br /> Commercial General Liability,Hired and Non-Owned Auto Liability and Employers Liability Policies.and Employers Liability Policies.Should any of the above
<br /> described policies be cancelled before the expiration date thereof,notice will be delivered in accordance with the policy provisions.Professional Liability is a
<br /> claims made policy and includes Waiver of Subrogation Provision as required by written contract.
<br /> 30-Day Notice of Cancellation is included per policy provisions.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POILICIFR HF cANrFLLFD RFFnRF
<br /> THE EXPIRATION DATE THEREO
<br /> ACCORDANCE WITH THE POLICY PR( HouN Risk ManagmwnfDivisim
<br /> REVIEWED&APPROVED BY:
<br /> City of Santa Ana AUTHORIZED REPRESENTATIVE Aecv
<br /> 44
<br /> Risk Management Divison
<br /> 20 Civic Center Plaza,4th Floor ��f•�� -� Risk Management specialist
<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
<br />
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