Laserfiche WebLink
°L CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY) <br />DS(W2024 <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />Risk Services Central, Inc. <br />cago IL O ce <br />East Rarlijinliph n /y I <br />tags IL u U <br />sh Construction company II, LLC *MURER <br />:AFCh Indempity InsUranC¢ <br />0 EornPPoiMe COUrt St¢ 201 <br />ono A 92 USA 1IlAceve O NERR • -40 — <br />NAIC# <br />O <br />0 <br />d <br />c <br />m <br />a <br />0 0 <br />S <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. Limits shown are as requested <br />LTR <br />TYPE OF INSUflANCE <br />INSO <br />WVO <br />POLICY NUMBER <br />MMIDDIYYY <br />MMADD(YYYYI <br />LIMITS <br />A <br />GENERAL LIABILITY <br />Y <br />Y <br />41PKG8901918 <br />EACH OCCURRENCE <br />$2,000,000 <br />SIR applies per policy terns <br />& COOdi <br />ions <br />4COMMERICIA4. <br />ENTE <br />RENTED— <br />Ea occurrence) <br />$1,000,000PREMISES <br />CLAIMS MADE �XOCCUR <br />MED EXP(Any one person) <br />$25,000 <br />PERSONAL& AOV INJURY <br />$2,000,ODO <br />.!a. <br />a <br />GENT AGGREGATE LIMITAPPLIES PER: <br />GENERALAGGREGATE <br />$4,000,000 <br />POLICY [fl�ET X�LOC <br />0 <br />PRODUCTS-COMPIOP AGO <br />$4,000,000 <br />OTHER: <br />o <br />n <br />A <br />AUTOMOBILE LIABILITY <br />41PKG8901918 <br />06/01/202406/01/2025 <br />COMBINED SINGLE LIMIT <br />EaaaccomeccMent <br />$5,000,000 <br />ADS <br />BODILY INJURY I Per parson) <br />A <br />X ANYAUTO <br />41CA88902018 <br />06/01/202406/01/2025 <br />Z <br />OWNED SCHEDULED <br />MA ONLY <br />N <br />BODILY INJURY(Per acciahmn <br />AUTOS <br />HIRDEO FONL NON-0WNEO <br />U <br />PROPERTY DAMAGE <br />ONLY AUTOS ONLY <br />Par amMenl <br />L <br />N <br />A <br />UMBRELLAu" <br />X <br />OCGUR <br />41UFP1992101 <br />06/01/2024 <br />06/01/2025 <br />EACH OCCURRENCE <br />$5, 000, 000 <br />U <br />X <br />EXCESS LIAR <br />CLAIMSiMOE <br />AGGREGATE <br />$5,000,000 <br />DEO <br />IRETENTION <br />B <br />WORKERS COMPENSATION AND <br />44WC18937511 <br />06 01 2024 <br />06 Ol 2025 <br />X PER STATUTE OTH- <br />EN <br />EMPLOYERS' LIABILRV yIN <br />A05 <br />EL EACHACCIDEM <br />$1,000,000 <br />A <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERNIEMBER EXCLUDED? N <br />NIA <br />41WC18910911 <br />06/01/2024 <br />06/01/2025 <br />E.LDISEASE-EAEMPLOYEE <br />$1.000.000 <br />(Mandatory in NM <br />FL <br />DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is required) <br />RE: Lease Agreement between The city of Santa Ana and Walsh Construction company II, LLC for use of property located at 1000 <br />East Santa Ana Boulevard in the City of Santa Ana - Santa Ana Regional Transportation center (SARTC), suite 200 and portions o <br />the parking area not presently occupied. Walsh Project: OC streetcar construction - Project IFB 7 - 1904, Job No.: 218132. see <br />attached. <br />CERTIFICATE HOLDER <br />City of Santa Ana <br />Public works Agency <br />Attn: Executive Director of <br />Public works Agency <br />20 Civic Center Plaza (m-21) <br />Santa Ana CA 92701 USA <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />OR4 <br />©1988-2015 ACORD C( <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />,yt RmkMAmgntne[IAwisrt <br />vl+eY I � �VIE�1'Jm6APPRtNm BY: <br />Aj, Arm <br />Risk Management SpeoAut <br />