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AC R CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD YYYY)
<br /> 10/28/2024
<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
<br /> NAME: Danny Ho
<br /> Alliant Insurance Services PHONE FAX
<br /> 101 Park Ave 18th Fl A/C No Extl:212-603-0316 IA/C,No):
<br /> L.
<br /> New York NY 10178 (A/C
<br /> CBGCOI@alliant.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC H
<br /> License#:0C36861 INSURER A:Phoenix Insurance Company 25623
<br /> INSURED COOKSOA-01 INSURER B:Travelers Property Casualty Co 25674
<br /> dba Communications,o etNtInk. INSURER C:Travelers Indemnity Company of 25682
<br /> Blue Violet Networks
<br /> 17815 Newhope St., Suite M INSURERD:
<br /> Fountain Valley CA 92708 INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1548418967 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 ADOL SUBR POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER ,IMM/DD/YYYY) IMM/OD/YYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y Y-630-0R561236-PHX-24 6/15/2024 6/15/2025 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE X OCCUR DAMAGE TO RENTED
<br /> PREMISES(Ea occurrence) $1,000,000
<br /> X Contractual Llab MED EXP(My one person) $10,000
<br /> X X,C,U Coverage PERSONAL&ADV INJURY $1,000,000
<br /> GENII AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY X JECT X LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY Y Y Y-810-0R561251-TCT-24 6/15/2024 6/15/2025 (EaeccdeDtSINGLE LIMIT $1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY (Per accident)
<br /> B X UMBRELLALIAB X OCCUR Y Y CUP-3T402591-24-14 6/15/2024 6/15/2025 EACH OCCURRENCE $25,000,000
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $25,000,000
<br /> DED X RETENTION$n $
<br /> C WORKERS COMPENSATION Y UB3T0 8 5 3 35-24-14-G 6/15/2024 6/15/2025 X P OTH-
<br /> AND EMPLOYERS'LIABILITY V/N STAER TUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBEREXCLUDEDT N NIA
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> It yes,describe under
<br /> DESCRIPTION OF OPERATIONS below EA.DISEASE-POLICY LIMIT $1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> The Certificate Holder is included as Additional Insured(Al)on the General Liability(GL)for Ongoing&Completed Operations,Automobile Liability(AL)&
<br /> Umbrella(UM)policies on a Primary and Non-Contributory Basis and Waiver of Subrogation is granted in favor of the Al as per the policy provisions of the GL,
<br /> AL,Workers'Compensation(WC)&UM policies as required by written contract. A 30 day notice will be given to the persons or organizations shown in the
<br /> schedule for cancellation or non-renewal of the GL,AL,WC&UM policies for any statutory reason other than non-payment of premium. As per the policy
<br /> provisions,UM Policy follows form to the GL Policy and UM limit sits over the GL,AL&WC limits.
<br /> City of Santa Ana,Its City Council,Affiliates, Employees,Agents and/or Assignees are included as Additional Insured where required by written contract.
<br /> Coverage is primary and non-contributory and a Waiver of Subrogation applies as required by written contract. Includes 30 Days Notice of Cancellation.Ten
<br /> (10)days prior written notice for non-payment prior written notice for policy cancellation shall be provided to City.
<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 PROVISIONS.
<br /> City of Santa Ana
<br /> 20 Civic Center Plaza M-11
<br /> Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br /> ©1988-2015 ACORD CORPORATION All rlahts reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD APPROVED
<br /> By Cynthia Mora at 8:12 am, Oct 31,2024
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