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PGH WONG ENGINEERING, INC. (2)
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PGH WONG ENGINEERING, INC. (2)
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Last modified
8/9/2024 2:50:22 PM
Creation date
8/9/2024 2:45:44 PM
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Contracts
Company Name
PGH WONG ENGINEERING, INC.
Contract #
A-2024-101
Agency
Public Works
Council Approval Date
7/16/2024
Expiration Date
7/16/2025
Insurance Exp Date
12/18/2024
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DATE (MWDO/1'YYY) <br />12f7/2023 <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 />IMPUK IAN I : IT true certificate nolder Is an Awl I IUNAL INb UKEU, the pollcypes) must nave ADui I IONAL INJUKtU 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 riahts to the certificate holder in lieu of such endorsementfsl. <br />PRODUCER <br />Greyling Ins. Brok ge/EPIC a <br />3780 Mansell Ro uingie <br />Alpharetta GA 3 <br />INSURED <br />PGH Wong Engineering, Inc. <br />182 2nd St. Suite <br />San Francisco C 105 <br />COVERAGES <br />SURE <br />13604 <br />11000 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEr, 97. OW HAVE BEEN ISSUED O TH 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 <br />LTR <br />TYPE OF INSURANCE <br />ADD <br />2M <br />POLICY NUMBER <br />POLICYEFF <br />MWDDrrrM <br />EXP <br />(MMQDIYYM <br />LIMITS <br />A <br />X <br />COMMERCU6.GENERALLIABILITY <br />20UENOK8HIA <br />12/18/2023 <br />12/18/2024 <br />EACH OCCURRENCE <br />$1.000,000 <br />CLAIMS -MADE I —XI OCCUR <br />PREMSES Eaoaurrence <br />$300,000 <br />MED EXP (Any one person) <br />$10,000 <br />PERSONAL&ADV INJURY <br />$1,000.000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE <br />$2,000.000 <br />POLICY JECOT [X] LOG <br />PRODUCTS - COMP/OP AGG <br />$2,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />20UENOK8020 <br />12/18/2023 <br />12/18/2024 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />IX <br />BODILY INJURY (Per accident) <br />$ <br />X <br />PROPERTY DAMAGE <br />Per a... d l <br />$ <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />C <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />20XHUOK8HIG <br />12/1 B12023 <br />12/18/2024 <br />EACH OCCURRENCE <br />$10,000,000 <br />AGGREGATE <br />$10,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DEO X RETENTION$ <br />$ <br />E <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABIUDY YIN <br />20WEOKBHOS <br />12/18/2023 <br />12118/2024 <br />X STATUTE OERH <br />ANYPROPRIETOR/PARTNERIEXECUTIVE <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />OFFICERIMEMBEREXCLUDED? <br />N/A <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />(Mandatary in NH) <br />R yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />D <br />Professional Liability <br />1000633873231 <br />12/18/2023 <br />12/18/2024 <br />Per Claim <br />10,000,000 <br />Incl. Pollution Liability <br />Aggregate <br />10,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Re: 1000 East Santa A" Blvd., Ste. 220, Santa Ana 92701. The City of Santa Ana, its officers, employees, agents, volunteers & representatives are named as <br />Additional Insureds with respects to General Liability where required by written contract. The above referenced liability policies with the exception of workers <br />compensation and professional liability are primary & non-contributory where required by written contract. Waiver of Subrogation is applicable where required <br />by written contract & allowed by law. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' <br />written notice (except 10 days for nonpayment of premium) will be provided to the Certificate Holder. Umbrella Follows Form with respects to General, <br />Automobile & Employers Liability Policies. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF. <br />NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PRC <br />City of Santa Ana; Risk Management Division <br />20 Civic Center Plaza; 4th Floor <br />Santa Ana CA 92701 -0000 <br />)tiskp(yision <br />a e` <br />e� iZEV1EWED a'APPROV®BY: <br />' "'7f fkwa:e <br />Risk Management Sperialist <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2015 ACORD <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />
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