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A ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/o24vY>
<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
<br /> PHME: Lenessa Weatherford
<br /> Alliant Insurance Services, Inc.
<br /> PHONE FAX
<br /> 333 S Hope St Ste 3700 (A/C,No,Eat): (A/C,No):
<br /> Los Angeles CA 90071 ADDRESS: Lenessa.Weatherford@alliant.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:0C36861 INSURER A: Illinois Union Insurance Compa 27960
<br /> INSURED LOSANGE-29 -
<br /> Los Angeles Engineering, Inc. INSURER B:.'Uri .Acnm rich Insurancensel�f �alui-i 16535
<br /> 633 N.Barranca Ave. g • INSc:P•c nserAr e�omp�i 1i re "'➢ AI tg 11150
<br /> Covina, CA 91723 Angie Acevedo Acevedo
<br /> INSURER E: Date: 2024.10.02 14:53:49 07!O0r
<br /> INSUPcr.F:
<br /> COVERAGES CERTIFICATE NUMBER:1367387030 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
<br /> LTR INSD WVD. POLICY NUMBER (MM/DD/YYYYL(MMIDD/YYYY) LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY Y Y GLO 5630799-00 4/1/2024 4/1/2025 EACH OCCURRENCE $2,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $100,000
<br /> X BI/PD DED:$10k MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY X 12 LOC PRODUCTS-COMP/OP AGG $4,000,000
<br /> OTHER: $
<br /> l
<br /> B AUTOMOBILE LIABILITY Y Y BAP 5630798-00 4/1/2024 4/1/2025 OMBIJED SINGLE LIMIT $2,000,000
<br /> (Ea accident)
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY (Per accident) $
<br /> Liability Ded. $$0
<br /> C UMBRELLA LIAB X OCCUR US00138579L124A 4/1/2024 4/1/2025 EACH OCCURRENCE $10,000,000
<br /> X EXCESS LIAB CLAIMS-MADE
<br /> AGGREGATE $10,000,000
<br /> DED X RETENTION$Sin nnn $
<br /> B WORKERS COMPENSATION Y WC 5630797-00 4/1/2024 4/1/2025 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> It yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Pollution Liability COO G47457750 001 4/1/2024 4/1/2025 Each Occ./Aggregate $5,000,000
<br /> Professional Liability Each Occ./Aggregate $1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Re:Job#1566,Project#13-6792,Bristol Street Improvements and Widening from Civic Center Drive to Washington Avenue
<br /> City of Santa Ana, its City Council,officers,officials,employees,agents,and volunteers are included as Additional Insured as respects Liability arising out of
<br /> operations(work)performed by or on behalf of the Named Insured in accordance with the policy provisions of the General Liability and Automobile Liability
<br /> policies.The General Liability evidenced herein is primary and Non-Contributory to other insurance available to the Additional Insured,but only in accordance
<br /> with the policy provisions.Waiver of Subrogation applies as required by contract in accordance with the policy provisions of the General Liability,Automobile
<br /> Liability and Workers'Compensation policies.Cancellation notice will be delivered to the certificate holder in accordance with the provisions of the General
<br /> Liability,Automobile Liability and Workers'Compensation policies.
<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 /> City of Santa Ana roR.H RtskMaflagern�Dtviston
<br /> 20 Civic Center Plaza
<br /> Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Sri REVIEWED&APPROVED 8Y
<br /> - - 9), di Id`' ;'' A Acwe,clo
<br /> I �l
<br /> Risk Management Specialist
<br /> ©1988-2015 ACORD /
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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