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AcciRL? CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> `.� 08/08/2024
<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 /> MARSH USA LLC. NAME: Marsh I U.S.Operations
<br /> —
<br /> 155 N.WACKER,SUITE 1200 PHONE
<br /> No.Ext): 866-966-4664 FAX C No): 212-948 0770
<br /> CHICAGO,IL 60661 E-MAIL
<br /> ADDRESS: Ch VSJtRery SIQ a„h4ged by AngieAIC#
<br /> LOS Angie INSURER A: Old Ref,blipk rep r Jo, 24147
<br /> INSURED INSURER B: Indian ler,or Insurance Company 36940
<br /> PCL Construction Services,Inc.
<br /> 655 N.Central Avenue,Suite 1600 Acevedo INSURER C: See icord Da P2tE 24-10-01 15:49:44
<br /> Glendale,CA 91203
<br /> INSURER D:INSURER:: -0/7
<br /> r001
<br /> INSURER F:
<br /> —
<br /> COVERAGES CERTIFICATE NUMBER: CHI-010727452-03 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 SUER POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)_. LIMITS
<br /> A x COMMERCIAL GENERAL LIABILITY MWZY 313941.24 07/01/2024 07/01/2025 EACH OCCURRENCE $ 2,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 2,000,000
<br /> MED EXP(Any one person) $ 10,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY x PROT- LOC GENERAL LIABILITY EXCESS
<br /> PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> A OTHER: MWZX 316962-24 07/01/2024 07/01/2025 EXCESS LIMIT: $ 8,000,000
<br /> A AUTOMOBILE LIABILITY MWTB 313942-24 07/01/2024 07/01/2025 (Ea COMBINaccidEDent)SINGLE LIMIT $ 2,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY (Per accident) $
<br /> S
<br /> B UMBRELLA LIAB X OCCUR CPX42008711 07/01/2024 07/01/2025 EACH OCCURRENCE $ 20,000,000
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 20,000,000
<br /> DED RETENTIONS $
<br /> A WORKERS COMPENSATION MWC 313940-24(AK AL AR AZ CA CO 07/01/2024 07/01/2025 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> AN VPROPRIETOR/PARTNER/EXECUTIVE DE FL GA HI ID IL KY LA MA MD MN MS E.L.EACH ACCIDENT S 2,000,000
<br /> OFFICER/MEMBER EXCLUDED? N N/A
<br /> (Mandatory in NH) MT NC NJ OR PA SC SD TN TX UT VA E.L.DISEASE-EA EMPLOYEE $ 2,000,000
<br /> If yes,describe under WI) 2,000,000
<br /> DESCRIPTION OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT $
<br /> C 2ND EXCESS LIABILITY LAYER SEE ACORD 101 07/01/2024 07/01/2025 EACH OCCURRENCE 8,000,000
<br /> AGGREGATE 8,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The City of Santa Ana,its officers,officials,employees,and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf o
<br /> the Permittee including materials,parts,or equipment furnished in connection with such work or operations where required by written contract.Notice of cancellation is provided per the attached endorsements.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Risk Management Division THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
<br /> 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PRC\
<br /> Santa Ana,CA 92701 o NoEA
<br /> �cf Risk Ms»agemenntDivision
<br /> AUTHORIZED REPRESENTATIVE 't., c°.. REVIEWED&APPROV®BY:
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<br /> I � �� Risk Management Sped Mist
<br /> ©1988-2016 ACORD/ \
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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