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ACC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> ‘irm...."--- 11/01/2024
<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 Certificate Department
<br /> NAME: p
<br /> Assured Partners of California-Santa Ana PHONE (949)949)261-5335 FAX (949)261-1911
<br /> 2913 Pullman Street (A/C,No,Ext): (A/C,No):
<br /> E-MAIL certificates.nb@assuredpartners.com
<br /> ADDRESS:
<br /> Lic#0M07762 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Santa Ana CA 92705 INSURER A: Middlesex Insurance Company 23434
<br /> INSURED INSURER B: Starstone National Insurance Company 25496
<br /> PCN3,Inc. INSURER c: CM Vantage Specialty Insurance Company 15872
<br /> 11082 Winner Circle#B INSURER D:
<br /> INSURER E:
<br /> Los Alamitos CA 90720 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 24-25 GL,BA,UMB,WC 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.LLMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> TR A TYPE OF INSURANCE INSD `D 'D WVDD POLICY NUMBER POLICY EFF POLICY EXP
<br /> (MM/DDIYYYY) (MM/DD/YYYY) LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
<br /> DAMAGE TO RENTED -
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 500,000
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y Y A0144715001 01/13/2024 01/13/2025 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> POLICY X ROT n LOC 0000PRODUCTSCOMP/OPA OTHER: S
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> X ANY AUTO BODILY INJURY(Per person) S
<br /> A OWNED SCHEDULED Y Y A0144715003 01/13/2024 01/13/2025 BODILY INJURY(Per accident) $
<br /> _ AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> _ AUTOS ONLY _ AUTOS ONLY (Per accident)
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> A EXCESS LIAB CLAIMS-MADE A0144715002 01/13/2024 01/13/2025 AGGREGATE S 5,000,000
<br /> DED RETENTION$ $
<br /> -
<br /> WORKERS COMPENSATION X STATUTE OTH-
<br /> ER AND EMPLOYERS'LIABILITY YI N
<br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? Y N/A Y T10240890 04/01/2024 04/01/2025 .
<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 /> Each Occurrence $5,000,000
<br /> Excess Liability
<br /> C Per Occurrence CMVEXL004516101 01/13/2024 01/13/2025 Aggregate $5,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
<br /> ***Please see attached for additional coverages.***
<br /> RE:Renovation of Newhope Library(122 N Newhope St,Santa Ana,CA 92703)and Delhi Library(505 E Central Ave,Santa Ana,CA 92707)
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are named as Additional Insured on the GL per CG2037.0413 and
<br /> CG2010.0413,Waiver of Subrogation per CG2404.0509,Primary Non Contributory per CG2001.0413.Automobile Additional Insured with Primary Non
<br /> Contrubutory per CA7601.0615.Auto Waiver of Subrogation per CA0444.1013.Workers Compensation Waiver of Subrogation per WC040306.0484.
<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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza ,/
<br /> Santa Ana CA 92701 /t1'%re/i (t-- -
<br /> I
<br /> ACORD 25(2016/03) The ACORD name and logo are registered m APPROVED
<br /> By Cynthia Mora at 2:01 pm, Nov 05, 2022
<br />
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