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<br /> ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br /> I`� 09/06/2024
<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 CONTACT WTW Certificate Center
<br /> NAME:
<br /> Willis Towers Watson Insurance Services West, Inc.
<br /> c/o 26 Century Blvd (A/C No.Ext): 1-877-945-7378 `v/ S FAX
<br /> No): 1-888 467-2378
<br /> E-MAIL c� � �y� E i g n c d by
<br /> P.O. Box 305191 j
<br /> ADDRESS: cert tfi tNashville, TN 372305191 USA n le
<br /> NS R RAG
<br /> INSURERA: Lib tyAutual Fire In rance Corn any 23035
<br /> INSURED INSURER B: Ame .cp =P lrg3 +Wii9LP1lY�eVY d O 24066
<br /> Bernards Bros, Inc. —
<br /> 555 First Street INSURER C: LM Ins• nce��C�,�o,r��porate` {^' 3600
<br /> San Fernando, CA 91340 INS - -D: °=eadfa �e C +++4 2 , �7. 6387
<br /> eve • r .�4�V. rkflyray IN LCOVERAGES CERTIFICATE NUMBER:W34651414 NUR:
<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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR , D yyvo POLICY NUMBER IMM/DD/YYYYL1MMIDD/WYYL LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES ,D00
<br /> PREMISES(Ea occurrence) $
<br /> A MED EXP(Any one person) $ 15,000
<br /> Y Y TB2-661-067465-024 07/01/2024 07/01/2025
<br /> PERSONAL&ADVINJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> X POLICY PRO- LOC 4,000,000
<br /> PRO-
<br /> JECT PRODUCTS-COMP/OP AGG $
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> (Ea accident) $ 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) S
<br /> A OWNED SCHEDULED Y Y AS2-661-067465-034 07/01/2024 07/01/2025 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY _ AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY _ AUTOS ONLY (Per accident) $
<br /> S
<br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 10,000,000
<br /> B
<br /> X EXCESS LIAB CLAIMS-MADE EUA64965239 07/01/2024 07/01/2025 AGGREGATE S 10,000,000
<br /> DED RETENTIONS S
<br /> WORKERS COMPENSATION X STATUTE OERH AND EMPLOYERS'LIABILITY Y!N -
<br /> C ANYPROPRIETOR/PARTNERJEXECUTIVE E.L. 1,000,000
<br /> OFFICER/MEMBEREXCLUDED? N/A Y WC5-661-067465-014 07/01/2029 07/01/2025 .L.EACH ACCIDENT $
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If Ees, N under E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS below 1,000,000
<br /> D Contractor's Pollution Liab. EOC 0938665-00 07/01/2024 07/01/2025 Each Claim $10,000,000
<br /> Contractors Professional Liab. Each Claim $10,000,000
<br /> Policy Aggregate Per Policy
<br /> $10,000,000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Project: 1685 State Building Demolition
<br /> As respects to General Liability, Certificate Holder is an Additional Insured when required by written contract with
<br /> the named insured. As respects to General Liability, Waiver of Subrogation applies when required by written contract.
<br /> As respects to General Liability, coverage is Primary and Non-contributory for additional insured(s) when required by
<br /> SEE ATTACHED
<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 /> ACCORDANCE WITH THE POLICY PRC\
<br /> a„oa. Risk ManagernentDivision
<br /> City of Santa Ana
<br /> AUTHORIZED REPRESENTATIVEREVIEWED&APPROVED BY:
<br /> 20 Civic Center Plaza, M-28 1I5
<br /> ', A Aettagt4
<br /> Santa Ana, CA 92701 �' Risk Management Specialist
<br /> ©1988-2016 ACORD / \
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> SR ID: 26399028 aATcs' 3610872
<br />
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