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ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
<br /> `...----- 05/14/2024
<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 Ashley Greenberg
<br /> NAME:
<br /> Cornerstone Specialty Insurance Services,Inc. PHONE
<br /> Extl: (714)731-7700 FAX
<br /> No): (714)731-7750
<br /> 14252 Culver Drive,A299 • egI``Q IN RE tA RDING-COVERAGE ) NAIC#
<br /> Irvine fl I e CA 92604 Confine al Casualty Comp y 20443
<br /> INSURED I I U �erICJ .eQ.Vl0 20427
<br /> CAP Architecture URER c: RLI Insurance Company 13056
<br /> 8700 WarnerAv ue l D .• tQ• 2 024.0 5•1 7 -
<br /> Suite 280 INSURER JE-��.•...�^•• 1
<br /> Fountain Vail
<br /> s 1105.15 —07fpgf
<br /> COVERAGES CERTIFICATE NUMBER: -4/25 COVERA E • • R N 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 AUUL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY)_ LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000
<br /> DAMAGE TO RENTED 1,000,000
<br /> CLAIMS-MADE n OCCUR PREMISES(Ea occurrence) $
<br /> X ADDT'L INSURED/P&NC MED EXP(Any one person) $ 10,000
<br /> A X BLNKT WVR OF SUBRO Y Y 5094175320 05/18/2024 05/18/2025 PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY n PRO n LOC 4,000,000
<br /> PRODUCTS-COMP/OPAGG $
<br /> OTHER: _ $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> ANY AUTO BODILY INJURY(Per person) S
<br /> A OWNED SCHEDULED Y Y 5094175320 05/18/2024 05/18/2025 BODILY INJURY(Per accident) S
<br /> AUTOS ONLY AUTOS
<br /> X HIRED N., NON-OWNED PROPERTY DAMAGE $
<br /> _ AUTOS ONLY AUTOS ONLY (Per accident)
<br /> $
<br /> X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000
<br /> A EXCESS LIAB CLAIMS-MADE 5094854763 05/18/2024 05/18/2025 AGGREGATE $ 1,000,000
<br /> DED X RETENTION$ 1D,DDD $
<br /> WORKERS COMPENSATION �/ MUTE EMPLOYERS'LIABILITY /� STATUTE ER -
<br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N E.L.EACH ACCIDENT $ 1,ODO,000
<br /> OFFICER/MEMBER EXCLUDED? N N/A Y 5094854715 05/18/2024 05/18/2025
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> dyes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Each Claim $1,000,000
<br /> Professional Liability
<br /> C Claims Made RDP0050717 05/18/2024 05/18/2025 Annual Aggregate $2,000,000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:Agreement No.A-2020-230-09 to Provide On-Call Space Planning and Architectural Consulting Services
<br /> The City of Santa Ana,its officers,employees,agents,volunteers and representatives are named Additional Insured for General Liability but only if required
<br /> by written contract with the Named Insured prior to an occurrence and as per attached endorsement.Coverage is subject to all policy terms and conditions.
<br /> *30 days notice of cancellation,except for 10 days notice for non-payment of premium.For Professional Liability coverage,the aggregate limit is the total
<br /> insurance available for all covered claims reported within the policy period.
<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 /> City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PRO'\
<br /> �+!'-'''!�e Risk Mimegentott Divisim. Ti.
<br /> 20 Civic Center Plaza of♦�4i REVIEWED&APPROVED Br AUTHORIZED REPRESENTATIVE of �� li
<br /> is
<br /> AArr A A4evek 4'1
<br /> Santa Ana CA 92702 ' �',, a
<br /> I — -' Risk Management Specialist
<br /> ©1988-2015 ACOF/
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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