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ACa® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br /> �----- 12/26/2023
<br /> —
<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 SUBROGATIOal IS WAIVED,subject to the terms and col.ditigf�oat�.Rtqlo{,peawc att,�'�quiq� •r_... ement. A statement on
<br /> AIfi e t confer rights to the certificate hole le•r ip.NeltQl or IJ�/ /"�
<br /> ER d CONTACT Erica Hornaday
<br /> The Empire Cep any Aceve IQN FAX
<br /> o,Extl: (A/C,No):
<br /> 550 North Park Center Drive E-MAIL e(F}QJr[ny��d mp e--�.j{o.c tnJ7
<br /> A2vin Date: 2 5 .VT ��d
<br /> R(S!AFPORAIN�VYERAGE NAILVi
<br /> napCA 92 i l/��NNSURERA: Sentinel Insurance Company,LTD 11000
<br /> INSURED O 7 0�+ INSURER B: Trumbull Insurance Company 27120
<br /> RSG,Inc. INSURER C: Navigators Specialty Insurance Company 36056
<br /> 170 Eucalyptus Avenue INSURER D:
<br /> Suite 200 INSURER E:
<br /> Vista CA 92084 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 24/25 Master 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 U
<br /> LTR TYPE OF INSURANCE INSD D POLICY NUMBER POLICY EFF POLICY EXP
<br /> {MM/DD/YYYY)_(MM/DDlYYYYL LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY 1 00p 000
<br /> EACH OCCURRENCE $
<br /> DAMAGE TO RENTED -
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 1,000,000
<br /> MED EXP(Any one person) S 1 DO00
<br /> A Y Y 72SBAAQ7019 01/01/2024 01/01/2025 PERSONAL&ADVINJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<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 72SBAAQ7019 01/01/2024 01/01/2025 BODILYINJURY(Peraccident) S
<br /> AUTOS ONLY _ AUTOS
<br /> X HIRED ./ NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY (Per accident)
<br /> $
<br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> A EXCESS LIAB CLAIMS-MADE 72SBAAQ7019 01/01/2024 01/01/2025 AGGREGATE $ 2,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> WORKERS COMPENSATION X STATUTE EORH
<br /> AND EMPLOYERS'LIABILITY Y IN
<br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE NfA Y 72WECVK8727 01/01/2024 01/01/2025 E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED.
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S
<br /> AGGREGATE LIMIT 4,000,000
<br /> Errors&Omissions
<br /> C Claims Made CH24MPLX0058ONC 01/01/2024 01/01/2025 EACH CLAIM 2,000,000
<br /> DEDUCTIBLE 10,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> RE:RFQ No.21-107 Affordable Housing Financial,Analytical And Advisory Services.
<br /> City of Santa Ana,its officers,officials,employees,and volunteers are named as additional insured on this policy pursuant to written contract,agreement,or
<br /> memorandum of understanding.Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be excess and
<br /> non-contributory under the General Liability,where required by written contract,per form(SS 00 08 04 05)and(SS 00 08 04 05).General Liability is Primary
<br /> and Non-Contributory per form(SS 00 08 04 05).General Liability and Worker's Compensation Waiver of Subrogation per forms(SS 00 08 04 05)and(WC
<br /> 04 03 06).
<br /> *30 day notice of cancellation applies.
<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 PRO1\ /
<br /> o °s`sa, RiekManagementDMalcr t
<br /> 20 Civic Center Plaza cl AUTHORIZED REPRESENTATIVE ' c�, REVIEWED&APPROVED BY: •
<br /> (M-28)
<br /> J), e.,� A.,�,e A� �
<br /> 1 Santa Ana CA 92702 V ^`�� '. Risk Management Specialist
<br /> ©1988-2015 ACOF/
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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