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AC RD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> `------ 8/27/2024
<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: Sandy Peters
<br /> AssuredPartners Design Professionals Insurance Services, LLC PHONE FAX
<br /> 3697 Mt. Diablo Blvd Suite 230 fA/C No.Ext): 626-696-1901 (A/C,No):
<br /> E-MAIL
<br /> Lafayette CA 94549 ADDRESS: �erta; iO�s IDre�ii�rtn•,�rlc err by A n g i QAlc a
<br /> Angie License# 6003745 INSURERA: raVL/jl{eIj$P?[[ol���[t Aualty
<br /> Company of
<br /> America
<br /> America 25674
<br /> INSURED WESTDES-04 INSURER B 1 -SVQre1'S -aYt.R 110 SuretyCo of America 31194
<br /> Westgroup Designs, Inc. —
<br /> 949-250-0880 INSURER' :TheMitee jn �t
<br /> ' ' 9.12682
<br /> 19900 MacArthur Blvcj10C e V/ INSURE'.D: � �
<br /> Irvine CA 92612 �"�", e d 0
<br /> INPUF.::RE: a rnnl
<br /> ,N''JRER F:
<br /> COVERAGES CERTIFICATE NUMBER:753376190 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 ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 6806H393952 10/1/2024 10/1/2025 EACH OCCURRENCE $1,000,000
<br /> _ CLAIMS-MADE X OCCUR DAMAGE TO RENTED
<br /> PREMISES(Ea occurrence) S 1,000,000
<br /> X Contractual Liab MED EXP(Any one person) S 10,000
<br /> Included PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY Y Y BA25471737 10/1/2024 10/1/2025 COMBINED SINGLE LIMIT S1,000,000
<br /> (Ea accident)
<br /> X ANY AUTO BODILY INJURY(Per person) S
<br /> OWNED SCHEDULED BODILYINJURY(PerS
<br /> AUTOS ONLY AUTOSaccident)
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY (Per accident) $
<br /> $
<br /> A X UMBRELLA LIAB X OCCUR Y Y CUP6C746237 10/1/2024 10/1/2025 EACH OCCURRENCE $1,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000
<br /> DED X RETENTION$❑ $
<br /> A WORKERS COMPENSATION Y UB85487537 10/1/2024 10/1/2025 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 /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Professional Liability& 105677979 9/9/2024 9/9/2025 Per Claim/52,000,000 $2,000,000/Aggr.
<br /> Contr.Pollution Liab Included
<br /> Claims Made Form
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> AM Best rating for all Travelers Policies listed:A++,XV
<br /> The Umbrella Policy is follow form to its underlying Policies:General Liability/Auto Liability/Employers Liability.
<br /> Project:RFP#20-040, On-Call AS for City's Public Works Agency--the City of Santa Ana,its officers,employees,agents,volunteers and representatives are
<br /> named as an additional insured as respects general liability as required per written contract.General Liability is Primary/Non-Contributory per policy form
<br /> wording.Insurance coverage includes waiver of subrogation per the attached endorsement(s). CANCELLATION/CHANGE:30 day notice will be sent to the
<br /> certificate holder.
<br /> CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF. NOTICE WILL RE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PRC\ /
<br /> City of Santa Ana, Risk Mgmnt Div. Risk Management Division
<br /> 20 Civic Center Plaza, 4th Floor AU RIZEDREPRES TATIVE j( REVIEWED&APPROVED BY:
<br /> Santa Ana CA 92702 QL. I•'�`
<br /> �(((,.,//////���' A-/lav 4
<br /> will ' 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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