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,a`oRo° CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYW)7/12/2024
<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 endorsement(s).
<br />PRODUCER
<br />AssuredPartners Design Professionals Insurance Services, LLC
<br />3697 Mt. Diablo Blvd Suite 230
<br />CA 94549
<br />CONTACT
<br />NAME: Helen Jang
<br />PHONE FAX
<br />A/C No EXt: 626-696-1892 (A/C, No):
<br />E-MLafayette
<br />ADDRESS: CertsDesignPro@AssuredPartners.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Travelers Property Casualty Company of America
<br />25674
<br />License#: 6003745
<br />INSURED GROUP4ARC
<br />INSURERB: The Travelers Indemnity Company of Connecticut
<br />25682
<br />Group 4 Architecture
<br />Research + Planning, Inc.
<br />IlvsuRERc: Travelers Casualty and Surety Company
<br />19038
<br />INSURERD:
<br />211 Linden Avenue
<br />South San Francisco CA 94080
<br />INSURERE:
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:548340738 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />6803J225448
<br />7/18/2024
<br />7/18/2025
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE OCCUR
<br />PREMISES DAMAGE TO
<br />PREMISES Ea occurrence)
<br />ccurrence
<br />$ 1,000,000
<br />X
<br />MED EXP (Any one person)
<br />$ 10,000
<br />Contractual Liab
<br />X
<br />Included
<br />PERSONAL 8 ADV INJURY
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY PRO-
<br />JECT LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />BA9R464848
<br />7/18/2024
<br />7/18/2025
<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 />BODILY INJURY (Per accident)
<br />$
<br />X
<br />FIR ERTYDAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />X
<br />$
<br />NoOwned Auto
<br />A
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CUP9G286032
<br />7/18/2024
<br />7/18/2025
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />AGGREGATE
<br />$ 4,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />PER OTH-
<br />STATUTE ER
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT
<br />$
<br />OFFICE R/MEMBER EXCLUDED? ā
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$
<br />C
<br />Professional Liability
<br />108087505
<br />7/22/2024
<br />7/22/2025
<br />$2,000,000 per Claim
<br />$2,000,000 Annl Ag
<br />Claims Made Form
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Insured owns no company vehicles; theirefore, hired/non-owned auto is the maximum coverage that applies. The Excess -Umbrella Liability is Follow Form to
<br />its underlying Policies: General Liability and Automobile Liability.
<br />REF: Santa Ana Library/ 22575-01 -Santa Ana Main Library Renovation, Santa Ana GENERAL LIABILITY/AUTOMOBILE LIABILITY ADDITIONAL INSURED:
<br />The City, its officers, officials, employees, and volunteers are named as Additional Insured as respects General Liability and Auto Liability as required per
<br />written contract. General Liability is Primary/Non-Contributory per policy form wording. Waiver of Subrogation applies to Commercial General Liability and
<br />Automobile Liability. Professional Liability Retro Date: Professional Liability Prior Acts Date 01/01/1974. CANCELLATION: 30 day notice will be sent to the
<br />certificate holder.
<br />L,r-M I Ir'IL A I C nULUCK
<br />City of Santa AnaU '7
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana CA 92702
<br />Iā- , _...... L ANL r_LLA I IUIV OU Uay Ivouce will De sent io nooer
<br />C>! qi <--A e SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />R,,kMaa ge THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZEJDJREPRESENTATIVE
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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