|
,---1
<br /> ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br /> kini.....----- 1/1/2025 8/15/2024
<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 Lockton Companies NNAMEACT
<br /> 3280 Peachtree Road NE,Suite#1000 PHONE FAX Ext): _ INC.No):
<br /> Atlanta GA 30305 E-MAIL Diaitall' signed by
<br /> (404)460-3600 AngICe INSURE;SI AFFOR G COVERA ADDRESS: _
<br /> NAIC
<br /> INSURER A: National Fir [nS a a rt((� 8
<br /> INSURED ENTRUST Soultions Group INSURER B: Valley For': '1Et}cB�t�} iiy eved 47508
<br /> 1533719 28100 Torch Parkway,Suite 400 INSURER C; The Cont tenta. ura a Com
<br /> Warrenville IL 60555 I ER D; American r,sualiy C E •'e r '24 I •
<br /> A c e v e SDsuJj\2�R E: Llov s of London f
<br /> IN3IIRERF: — 08 22 -
<br /> Sy U/ UU
<br /> COVERAGES CERTIFICATE NUMBER: 20838512 REVISION NUMBER: XXXXXXX
<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 /> INSD WVD POLICY NUMBER IMM/DDIYYYY)LJMMIDD/YYYY), LIMITS
<br /> A x COMMERCIAL GENERAL LIABILITY y y 7063806176 1/1/2024 1/1/2025 EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE x OCCUR DAMAGE TO RENTED 1 PREMISES(Ea occurrence) $ 000,000
<br /> MED EXP(Any one person) $ 15,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X I POLICY PE n LOC
<br /> HPRODUCTS-COMP/OP AGG $ 2,000,000
<br /> $
<br /> —'I(OTHER:
<br /> B AUTOMOBILE LIABILITY Y N 7063802032 1/1/2024 1/1/2025 (EOaaccldeniSINGLELIMIT $ 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX
<br /> AUTOSO ONLY _SCHEDULED BODILY INJURY(Per accident $ XXXXXXX
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY _AUTOS ONLY (Per accident) $ XXXXXXX
<br /> $ XXXXXXX
<br /> C UMBRELLA LIAB X OCCUR Y N 7063806498 I/1/2024 1/1/2025 EACH OCCURRENCE $ 25,000,000
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 25,000,000
<br /> DED X RETENTION$10,000 $ XXXXXXX
<br /> D WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN N 7063802242-AOS 1/1/2024 1/1/2025 X STATUTE ER
<br /> C ANY PROPRIETOR/PARTNER/EXECUTIVE I I NIA 7063803679-CAOnIy 1/1/2024 1/1/2025 E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> Ir yes,describe antler
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> E Professional Liab-A&E N N B0146LDUSA2405211 I/1/2024 1/1/2025 Limit:SI OM Each Claim
<br /> SIOM Policy Agg
<br /> Pollution Liab Ded: S750K
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> The City of Santa Ana,its officers,employees,agents and representatives is/are included as additional insured(except workers'compensation and
<br /> Professional Liability)where required by written contract. This insurance is Primary and Non-Contributory over any existing insurance and limited to
<br /> liability arising out of the operations of the named insured and where required by written contract. Waiver of subrogation is applicable where required by
<br /> written contract.
<br /> CERTIFICATE HOLDER CANCELLATION See Attachments
<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 /> 20838512 AUTHORIZED REPRESENTATIVE
<br /> \ /
<br /> City of Santa Ana
<br /> ,,,."' Risk Man gefnentDivision
<br /> 20 Civic Center Plaza tt c _ REVIEWED&APPROVED BY:
<br /> Risk Management Div,4th Floor 0. tt�11 �d
<br /> Santa Ana CA 92701 gem Spever�o® Risk Management SpecialistACORD 25(2016/03) ©1988=20est-i4;-.7CORP(/
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|