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COVER-1 OP ID: LW <br /> .Acorrca" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) <br /> 05/07/2024 <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 suchp endorsement(s). <br /> PRODUCER 916-960-8718 � 1 n2mE- ACT Lory Williams <br /> ISU/Francis-Pinney Ins. f PHONE 916-960-8718 FAX 916-773-4484 <br /> 2266 Lava Ridge Court St 00 0,Exit • (A/C,No): <br /> P.O.Box 619050 I �� �I <br /> Roseville,CA 95661-905 - <br /> Lory Williams °: p I(NNSSUU RIS)AFFFF��' ING COVERAGE NAIL N <br /> INSURED Consulting Partners Inc. I ra AA ✓ un- "r�eVed O <br /> J.Bradley Wilkes , URER C U <br /> 5016 Brower Court <br /> Granite Bay,CA 95746A1//4r ■/�//�', r rvs ' �A 7n7a 06• <br /> "I <br /> —C ,ft-'IT///VV'��""u" 'DREk //4�r"q • nn <br /> COVERAGES E IC E N �B �'2T•S 2 ® EVWI@M NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANC (STD BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE I URANCE 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD IMMIDDIYYYY) /MM/DDJYYYYI <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR X X PHBX23003419 10/10/2023 10/10/2024 PRFMSES/F.nNT1EDnce) $ 50,000 <br /> .Li . ': , MED EXP,AnY one eurscnl . , $ -10,000 <br /> _ _ 1 <br /> 1 ; PERSONAL&ASV INJURY I $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: I GENERALAGGREGATE $ 3,000,000 <br /> X POLICY JEC <br /> ( PRO-T LOC2,000,000 <br /> PRODUCTS-COMP/OP AGG I $ <br /> OTHER: <br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> (Ea accident) $ <br /> ANY AUTO PHBX23003419 10/10/2023.10/10/2024 i BODILY INJURY(Per person)_ $ <br /> OWNED <br /> AUTOS ONLY (SCHEDULED <br /> AUTOS p racciden t)pBODILY INJURY(Per accident) $ <br /> X I AUTOS ONLY X AUTO ONEV tPeAMACE $ <br /> NOHA AGG $ 3,000,000 <br /> A X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 <br /> EXCESS LIAB CLAIMS-MADE, IPHUB893341 12/15/2023110/10/2024 AGGREGATE $ 1,000,000 <br /> i DED , X I RETENTION$ 10,0001 — -$ <br /> B AND EMPLOY COMPENSATION <br /> V/N X STATUFE OTH- <br /> ER WEC BB2L9J 11/01/2023 11/01/2024 1,000,000 <br /> ANYIPRO PRIEBORR/PARTNERE/ ECUTIVE N/A E.L.EACH ACCIDENT $ <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 MISC Professional PHSD1831334 12/15/2023 10/10/2024 CLM/AGG 2M/4M <br /> DED/CLM 10,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS)VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> RE:CA Professional Service Provided by the Named Insured <br /> The City of Santa Ana, its officers, officials,employees,and volunteers <br /> are included as Additional Insured,as respects to General Liability per Form <br /> PI-BOP-003,with Primary/Non-Contributory per Form PI-BOP-011 and Waiver of <br /> Subrogation per Form BP0497 0106.When Required by Written Contract. <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITYSAN <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF "^� "" " ^^ ""^'^ "' <br /> City of Santa Ana ACCORDANCE WITH THE POLICY PR(\ <br /> Risk Management Division _ : - littakkManagarent1 sIwr <br /> 9 + RWIEUVEO 8 ArPxovq$BY: <br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <br /> : A T <br /> Santa Ana, CA 92702 7tt 7 i`s,ANrt,DNS <br /> I <br /> f 1fMnN nent$pecuuehst <br /> ACORD 25(2016/03) ©1988-2015 ACORD Ifs-=-E $ <br /> The ACORD name and logo are registered marks of ACORD <br />