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<br /> aC40 09/16/2025 1 " CERTIFICATE OF LIABILITY INSURANCE DATE(M /2025
<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 PHONE 1-877-945-7378 FAX 1-888-467-2378
<br /> A/C No Ext: A/C,No:
<br /> E-MAIL certificates@wtwco.com
<br /> P.O. Box 305191 ADDRESS:
<br /> Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: Liberty Mutual Fire Insurance Company 23035
<br /> INSURED INSURERB: American Fire and Casualty Company 24066
<br /> Bernards Bros, Inc.
<br /> 555 First Street INSURERC: LM Insurance Corporation 33600
<br /> San Fernando, CA 91340 INSURERD: Steadfast Insurance Company 26387
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: W40306383 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICYNUMBER MM/DD MM/DD
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> � OCCUR DAMAGERENTED
<br /> CLAIMS-MADE
<br /> PREMISESl(Ea occurrence) $ 300,000
<br /> A MED EXP(Any one person) $ 15,000
<br /> Y Y TB2-661-067465-025 07/01/2025 07/01/2026 PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 4,000,000
<br /> X POLICY❑ PRO-
<br /> POLICY ❑ LOC PRODUCTS-COMP/OPAGG $ 4,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ 1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED Y Y AS2-661-067465-035 07/01/2025 07/01/2026 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> B UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 10,000,000
<br /> X EXCESS LAB CLAIMS-MADE EUA(26)64965239 07/01/2025 07/01/2026 AGGREGATE $ 10,000,000
<br /> DED RETENTION$ $
<br /> WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> C ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A Y WC5-661-067465-015 07/01/2025 07/01/2026
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> D Contractor's Pollution Liab. Y EOC 0938665-01 07/01/2025 07/01/2026 Each Claim $10,000,000
<br /> Contractors Professional Liab. Each Claim $10,000,000
<br /> Policy Aggregate Per Policy $10,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> This Voids and Replaces Previously Issued Certificate Dated 06/25/2025 WITH ID: W39499273.
<br /> Project: 1885 State Building Demolition
<br /> As respects to General Liability, Certificate Holder is an Additional Insured when required by written contract with
<br /> SEE ATTACHED
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Tran Nguyen at 8:27 am,Sep 17,2025
<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 PROVISIONS.
<br /> City of Santa Ana Tu Tran DIgHa11y,ig-d by
<br /> Tb yen
<br /> Attention: Public Works Agency, Dar-2025.9.1
<br /> Date:2025.09.17
<br /> CIP/Design Engineering Nguyen 0827s1-07•00. AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza �J
<br /> Santa Ana, CA 92701, M-36
<br /> ©1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br /> SR ID: 28461569 BATCH: 4124893
<br />
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