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ACORbF CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDD/YYYY) F9i12r2024 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. 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). PRODUCER NAME: Behr Insurance Services Inc. FAX PHONE, 888-988-2347 AIC, NoExt : (A/C, No): ADDRESS: set-vice@behrins.com 1420 F Los Angeles Ave #203 INSURER(S) AFFORDING COVERAGE NAIC H Suni Valley • CA 9306 IqDk Arevedo 10499 INSURED /ALeVeU0 UR RB: 0 Concrete Construction Inc 10142 SHOEMAKER AVE INSURER D r INSURER E : SANTA FE SPRNGS CA 90670-3404 INSURER F : COVERAGES CERTIFICATE NUMBER: RFvi,;inN NIIMRFR- 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER {MMIDDIYYYY} (MMIDI IYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR PREMISES (EaTc,urrence} $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO. JECT POLICY ❑ PRO- ❑ LOC PRODUCTS - COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accidenq $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE FFICERIMEMBER EXCLUDED? �Y N r A y CTP1002477 05/08/2024 05/08/2025 STATUTE ER E.L. EACH ACCIDENT $ 1.000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required? RE: Project 922-9001 Legacy Square Transportation Improvements Waiver of subrogation applies for workers compensation per attached WC 04 03 06 endorsement. TE HOLDER City Of Santa Ana 20 Civic Center P.O. Box 1988 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PR( AUTHORIZED REPRESENTATIVE Jfta kaw fitter ©1988-2015 ACOR �- Ride MvvgwII D4vlslm7 REVIEWED& APPROVED BY: c i A+ju Ae4Nd Risk ManagementSpeciallst ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD