DOMINGUEZ GENERAL ENGINEERING, INC. (2)

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CERTIFICATE OF LIABILITY INSURANCE OAT 0620/20//024 2024Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER OF70482 1-562-270-0787 CONTA,: NAME: 'ah9a L,•Gurro JL Gurrola Insurance Age Anaie PHONE 5 Jr s E-MAIL cert catesno 1 100 N. Broadway Su1te 30ADORE.!: gia.c I SUAR(EL6FE0000V NAICp Long Beach, CA 90802 INSURI t,: a I 41297 INSURED Dominguez General Engineering, Inc. dba Dominguez General Hng rin n ct�\x' INSU' 2RB: Uni ed Financial Casualty Company 11770 L INP RERC: > T ie u e i"I �y p ny 16045 • 35378 11096 Pipeline Ave. V e 25674 ORE a Is sop rt Cas 1 Pomona 6 3A IN F: • • _ _ COVERAGES CFRTIFICATF NIIMRPR• 062r14 .n _ra oetnc nu wuaIA THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCEINSO gppL SUBR POLICY NUMBER MM/ODYEFF MM/DDfyY%1'Yl LIMBS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX OCCUR X X BCS2001121 12/15/23 12/15/24 EACH OCCURRENCE $ 11000,000 PREMISES Me occurrence) $ 300,000 X MET EXP (Any one person) $ 5,000 A Deductible: $ 5,.00 PERSONAL a ADV INJURY $ 100,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [X ] jEa1:1 LOG GENERALAGGREGATE $2,000,000 PRODUCTS - COMP/OP AGO $2,000, 000 $ OTHER: AUTOMOBILE LIABILITY X X 975624551 06/15/24 12/15/24 EO BINEauddeDISINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ B % ANY AUTO OWNED % SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED % NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident ; S UMBRELLA LIAB X OCCUR XLS2003316 12/15/23 12/15/24 EACH OCCURRENCE ; 4,000,000 AGGREGATE $ 4,000,000 A X EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 0.00 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILRY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERJMEMBEREXCLUDED? NIA X 760002485123E 10/O1/23 10/01/24 _ X STATUTE OERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ 1, 000, 000 DESCRIPTION OF OPERATIONS below H Property/Inland Marine X X QT-660-BS959975-TIL-23 10/01/23 10/01/29 Leased A Rented Bguipmeat $ 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORO 101, AddtUonal Remarks Schedule, may be attached R more space Is required) Re: Project No. 21-6453 NR Annexation water A Sewer Maint Improvements The City of Santa Ana, its of f i..... official., employees, and volunteer. are additional insured per attached endoreement(e). coverage is primary A non -contributor, per policy wording and attached endor.ement(s). waiver of euJorogation applies per attached endorsement(.). Rxce.. Liability 1. follow -form to the General, Auto and Rmployers Liability. 30 Day Notice of Cancellation/ 10 Day for Non -Payment rfrMN: C r1 VLYCR City of Santa Ana Risk Management Division 4th Floor 20 Civic Center Plaza Santa Ana CA 92701 USA ACORD 25 (2016103) JLGIA06 062024-01-GA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC AUTHORIZED REPRESENTATIVE Risk MumgemattlMsi A clo reel. _ REVIEWED F, APPROVED BY: ®. ® Risk Management Specialist The ACORD name and logo are registered marks of ACORD The ACORD name and logo are registered marks of ACORD