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�RD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY)
<br />0 8/13/2024
<br />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.
<br />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).
<br />PRODUCER CONTACT Erica Hornaday NAME: The Empire Company PHONE I rffc. Nol: IA/C No Extl: 550 North Park Center Drive E-MAIL ehornaday@empire-co.com ADDRESS: Suite 20 5 INSURER($) AFFORDING COVERAGE NAIC# Santa Ana CA 92705 INSURER A: Sentinel Insurance Company, LTD 11000
<br />INSURED INSURERS: Trumbull Insurance Company 27120
<br />RSG, Inc. INSURER C: Navigators Specialty Insurance Company 360 56
<br />170 Eucalyptus Avenue INSURER D: Suite 200 INSURER E: Vista CA 920 84 INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 24/25 Master 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 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER IMM/DDNYYYl IMM/DDNYYYl
<br />X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000 ,000 -D CLAIMS-MADE [8] OCCUR Ut\lVlt\'-'C: IUrs.r::i.1r::u 1,000 ,000 -PREMISES (Ea occurrence) $
<br />MED EXP (Any one person) $ 10,000
<br />A y y 72SBAAQ7019 01/01/2024 0 1/01/2025 PERSONAL & ADV INJURY $ 1,000,000
<br />2,000 ,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
<br />� POLICY □ j:g: □ LOC PRODUCTS -COMP/OP AGG $ 2,000,000
<br />OTHER: $
<br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,0 00 (Ea accident) ANY AUTO BODILY INJURY (Per person) $
<br />A -OWNED -SCHEDULED 72SBAAQ7019 01/01/2024 0 1/01/2025 AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ 25 HIRED 2$ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY /Per accident) $
<br />UMBRELLA LIAB � OCCUR EACH OCCURRENCE $ 2,000,000
<br />72SBAAQ7019 01/01/2024 01/01/2025 2,000,000 A EXCESSLIAB CLAIMS-MADE AGGREGATE $
<br />DED I XI RETENTI ON$ 10•000 $
<br />WORKERS COMPENSATION XI �ffTuTE I I OTH-
<br />AND EMPLOYERS' LIABILITY ER Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE 0 y 72WECVK8727 01/01/2024 01/01/2025 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A
<br />(Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ AGGREGATE LIMIT 4,000,000 Errors & Omissions C Claims Made CH24MPLX00 580NC 01/01/2024 01/01/2025 EACH CLAIM 2,000,000
<br />DEDUCTIBLE 10,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: RFQ No. 21-107 Affordable Housing Financial, Analytical And Advisory Services -Evidence of Renewal of Insurance applies to agreement dated
<br />9/6/2024. City of Santa Ana, its officers, officials, employees, and volunteers are named as additional insured on this policy pursuant to written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and non-contributory under the General Liability, where required by written contract, per form (SS 00 0 8 04 05) and (SS 00 0 8 04 0 5). General Liability is Primary and Non-Contributory per form (SS 00 0 8 04 05). General Liability and Worker's Compensation Waiver of Subrogation per forms (SS 00 0 8 04 05) and (WC
<br />04 03 0 6).
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana Risk Management Division
<br />20 Civic Center Plaza
<br />(M-28)
<br />Santa Ana CA 92702 I
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />�,YMAA--I I,,.., ,_. � n © 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />Rh�k Management Division
<br />R�vlewed and Approved by:
<br />��t
<br />Risk Manogl":r
<br />EXHIBIT 1
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