|
a� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br /> 10/25/2024
<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($),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(les)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 1etCT Marc Wright
<br /> The Liberty Company Insurance Brokers PHONE (888)918.3960
<br /> Lie#0079653 Mc�Lo,exlh M.No):
<br /> ADDRESS: mark.wrlghtQllbenyocmpanycom
<br /> 6066 De SoloAVe,Ste 260 INSURER(S)APFOROINu COVERAGE NAICO
<br /> Woodlend Hills CA 91367 INSURER A: Beazley Insurance Company,Inc. 37640
<br /> INSURED INSURER BI Stale Compensation Insurance Fund 35076
<br /> Abelian Enterprise INSURER O: United Financial Casualty Co 11770
<br /> dba SoCal Removal INSURER D: Colony Insurance Co. 39993
<br /> 1 640 E Edinger Ave,Unit C INSURER e l
<br /> Santa Ana CA 92705 INSURER P:
<br /> COVERAGES CERTIFICATE NUMBER: 24-26 GL BAWC POL REVISION NUMBER;THIS IS TO CERTIFYTHAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE 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 AWL Ma POLICY Err POLICY EXP
<br /> LTR TYPE OF INSURANCE INNS_ POLICY NUMBER IMMIDDNYTYIJMMIDDIYYYY)_ LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY
<br /> EACH OCCURRENCE $ 6,000,000
<br /> UAMAbb to RENTED
<br /> 6LAIMS.MADE In OCCUR PREMISES(Ea oeamrenco $ 60,000
<br /> —
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y Y ENC0004485-05 06/01/2024 06/01/2026 PERSONAL A ADV INJURY $ 6,000,000
<br /> GEN'LAGGREOATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000
<br /> X PO ICY n jEC I LOC PRODUCTS.COMP/OP Sao $ S,OOQ000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY (ggeraildeotj INGLELIMIT $ 1,000,000
<br /> X ANYAUTO BODILY INJURY(Per person) $
<br /> C " OWNED SCHEDULED 022643766 06/19/2024 12/19/2024 BODILY INJURY(per moon') $ONLY AUTOS
<br /> X HIRED NON BONED PROPERTY DAMAGE
<br /> AUTOS ONLY X AUTO60NLV (par accident) $
<br /> $
<br /> UMBRELLAUAB X OCCUR EACH OCCURRENCE $ 6,000,000
<br /> D X EXCESS LIAR CLAIMS-MADE XS177710 11/18/2024 11/18/2025 AGGREGATE $ 5,000,000
<br /> DED RETENTION$ $
<br /> WORKERS COMPENSATION p
<br /> AND EMPLOYERS'LIABILITY YIN X STATUTE I ERH
<br /> B ANYPRGPRIEroI&PARTNERrEXEOU1IVE ❑ N!A913113524 OS101/2024 06/01/2026 EL EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? y
<br /> (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ 1,O00,000
<br /> ibe under
<br /> DESCRIPs TION OF OPERATIONS below w 1,000,000
<br /> ._. EL.DISEASE-POLICY LIMIT $
<br /> Poltu0wl Each Occurrence 1,000,000
<br /> A Professional Liability Y Y EN00004485-06 06/01/2024 06/01/2026 General Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS)VEHICLES(ACORD;It Addlllanal Remarks Schedule,may be attached If momapace le required}
<br /> ProJect/h25-9002
<br /> Sixth Floor Renovations
<br /> The City of Santa Ana,Its officers,officials,employees,and volunteers are Included as an Additional Insureds under the Commercial General Liability on a
<br /> Primary/Non-Contributory basis when required by written contract.
<br /> APPROVED
<br /> By Cynthia Mora at 4:20 pm,Dec 02,2024
<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 /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702 ) )7,' (,J .4.: _2
<br /> I
<br /> @ 1088.2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo aro registered marks of ACORD
<br />
|