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�....41 GENEPUM-01 AGAGNON
<br /> A�ORO° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
<br /> 9/5/2024
<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 Amanda Gagnon
<br /> Smith Brothers Insurance,LLC PHONE 1 FAX
<br /> 68 National Drive (A/C,No,Ext):(36I wi 1 � {(,VG fNr�n ry j
<br /> Glastonbury,CT 06033 • E-MAILD :aga gn���- Ptttlicbtf��rlIs�a`b
<br /> A a i e Aceve
<br /> SING COVERAGE NAIC#
<br /> A:_IIP�•7z ;' Insurance Company20508
<br /> INSURED INSURER r.;Ameri a ity20l t1A4. d PO94". :2842O/1001
<br /> General Pump Company,Inc. IN Su tF t c:Continental Insurance Company(the) 35289
<br /> 159 North Acacia Street INSURER D:National Fire Insurance Company Of Hartford 20478
<br /> San Dimas,CA 91773 INSURER E:Nautilus Insurance Co. 17370
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 BYPAID CLAIMS.
<br /> INSR LTR JNSD SUBR1 POLICY EFF POLICY EXP LIMITS
<br /> TYPE OF INSURANCE POLICY NUMBER
<br /> A X COMMERCIAL GENERAL LIABILITY JMM/DDIYI'YYV IMMIDDlYWYL
<br /> EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR X X 7039961462 8/31/2024 8/31/2025 PREMISES(Es occurs nce) $ 100,000
<br /> MED EXP(Any one person) $ 5,000
<br /> P ERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APP LIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY X ma LOC PRODUCTS.COMP/OP AGG $ 2,000,000
<br /> OTHER:
<br /> $
<br /> B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> (Ea accident) $
<br /> X ANYAUrO 7039961476 8/31/2024 8/31/2025 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident)_ $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY (Per accident) $
<br /> $
<br /> C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 9,000,000
<br /> EXCESS LIAB CLAIMS-MADE 7039961509 8/31/2024 8/31/2025 AGGREGATE $ 9,000,000
<br /> DED X RETENTION$ 10,000
<br /> $
<br /> D WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y!N 7039961512 8/3112024 8/31l2025 STATUTE ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE v NIA ,000,000
<br /> FFICER/MEMBER EXCLUDED? E.L.. EACH ACCIDENT $
<br /> Mandatory In NH) EL DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,des cnbe under E.L.DISEASE LIMIT $ 1,000,000
<br /> DESCRIPTION OF OPERATIONS below
<br /> E Pollution/E&O CCP2044602-10 8/31/2024 8/31/2025 Liability 2,000,000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> City of Santa Ana,its officers,employees,agents,and representatives are included as Additional Insured as respects General Liability and Auto Liability as
<br /> per policy forms;coverage is primary and non-contributory;Waiver of Subrogation applies with respects to General Liability,Auto Liability and Workers'
<br /> Compensation as per policy forms.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City oraS nta Ana Risk Management Division THE--EXPIRATION—DATE THEREO\ -- ' -
<br /> ACCORDANCE WITH THE POLICY PRC Risk Mat)agententDitiislnn
<br /> 4th Floor oew --
<br /> 20 Civic Center Plaza R z EVIEWED&APPROVED BY: -
<br /> Santa Ana,CA 92702 AUTHORIZED REPRESENTATIVE af,i . `_ie Arty o
<br /> J Risk Management Specialist
<br /> IC— /.. - - - _ . _ __
<br /> ACORD 25(2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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