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ACc CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYI Y)
<br /> �------ 06/21/2024
<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 endor==ment(s).
<br /> PRODUCER CONT• e NAME/yT iro
<br /> Scott&McCauley Insuranc ncy (q/�n /xtl: 9 a y s Igoed
<br /> 2 Ritz Carlton Drive • i ADDRRE , coi@sminsuranceagency.com
<br /> Suite 204 ■
<br /> Dana Point CA 92629 INSUP �zIDol�ll FiR In )i!)ar� rt�pey,of J ar pc eve do
<br /> INSURED INS(' ER B: Transportation Insurance Company 1 20494
<br /> EBSGENE'. ENGINEERING,INC 35289
<br /> IN' iRER'URER C: iv i 07'. I I 20508
<br /> 1345 QUA' t .T STE
<br /> Suite 101 II III 410£ ♦ • RER
<br /> RERE:
<br /> CORON' _ CA F: _. (� , ,
<br /> COVERAGES CERTIFICATE NUMBER: EBS.Jer 2024-25 1 ,2 6 a NTr a00g OO
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW I AY_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 ADUL SUBR- POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER JMM/DD/YYYY) (MM/OD/YYYY) LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE OCCUR PREMISES lEa occurrence) $ 100,000
<br /> X $2,000 Deductible 15,000
<br /> MED EXP(Any one person) $
<br /> A Y Y 7018007493 02/01/2024 02/01/2025 PERSONAL&ADVINJURY $ 1.000,000
<br /> GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY 7PROT LOC
<br /> 0000PRODUCTS-COMP/OPAGG $ 0
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED Y Y 7018007509 02/01/2024 02/01/2025 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY _ AUTOS ONLY (Per accident)
<br /> $
<br /> X UMBRELLA LIAB X OCCUR $ 7,000,000
<br /> EACH OCCURRENCE
<br /> C EXCESS LIAB CLAIMS-MADE Y Y 7018007526 02/01/2024 02/01/2025 AGGREGATE $ 7,000,000
<br /> DED RETENTION$ $
<br /> WORKERS COMPENSATION X PER STATUTE EORH —
<br /> AND EMPLOYERS'LIABILITY
<br /> D ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N f A Y 7034507011 09/28/2023 09/28/2024 E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS below 1,000,000
<br /> Contractors Equipment
<br /> C 7018009485 02/01/2024 02/01/2025 Leased&Rented Equip $400,000
<br /> Owned/Scheduled Equip $1,579,500
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> EBS#24401
<br /> Project Name:PROJECT 22-1407,PEDESTRIAN AND MOBILITY IMPROVEMENTS PHASE III—ARPA I CSLFRF
<br /> Cit of Santa Ana,its officers,employees,agents and representatives are Additional Insureds with respect to General and Auto liability per the attached
<br /> endorsements as required by written contract.Insurance is Primary and Non-contributory.30 Days Notice of Cancellation with 10 days notice for non-pay in
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana Risk Management Division 4th Fir ACCORDANCE WITH THE POLICY PROM /
<br /> s''o�.,N�
<br /> 20 Civic Center Plaza Risk Management Division
<br /> AUTHORIZED REPRESENTATIVE REVI
<br /> 3" EWED&APPROVED BY:
<br /> ll
<br /> `4 > 1' A e Acevao
<br /> Santa Ana CA 92701 4 " —4 —, Risk Management Specialist
<br /> Sj
<br /> ©1988-2015 ACOF/
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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