Laserfiche WebLink
ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />ll%.� <br />DATEIMMIDDNYYY) <br />1 <br />3111 /2025 <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 <br />Venbrook Insurance Services <br />6320 Canoga Avenue, 12th Floor <br />Woodland Hills, CA 91367 <br />CONTACT <br />Venbrook insurance Services <br />PHONE FAx <br />s1a 59a s9ao A!D No: 818-59a-s910 <br />AOD"R'ESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Continental Insurance Company A XV <br />35289 <br />www.venbrook.com CA Lic No. OD80832 <br />INSURED <br />Cannon Corporation <br />1050 Southwood Drive <br />INSURER B : Hartford Casualty Insurance Company A+ XV <br />29424 <br />INSURER C ; Beazley Insurance Cam an , Inc. A XV <br />37540 <br />INSURER D ; <br />San Luis Obispo CA 93401 <br />INSURER E ; <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 84312285 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLIO#ES 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 />INSPOLICY <br />_LTRR <br />OF INSURANCE <br />ADDLITYPE <br />INSD <br />WVo SUER <br />POLICY NUMBER <br />EFF <br />r WDEVfYYYY) <br />POLICY EXP <br />(MUIDD[YYYYI <br />LIMITS <br />A <br />,/ <br />COMMERCIAL GENERAL LIABILITY <br />,/ <br />✓ <br />7039996776 <br />9/1/2024 <br />9/1/2025 <br />EACH OCCURRENCE <br />$1 000 000 <br />CLAIMS -MADE W OCCUR <br />PREM SESOEa e�ccuE ante <br />$ 100 000 <br />✓ <br />MED EXP (Any one person) <br />$15 000 <br />Contractual Liability <br />PERSONAL & ADV INJURY <br />$ 1 000 000 <br />GEN'LAGGREGATELIMIT APPLIES PER: <br />PHI - <br />POLICY [Z] JECT 7 LOC <br />GENERAL AGGREGATE <br />$2,000,000 <br />PRODUCTS - COMPIOPAGG <br />$2 000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />✓ <br />✓ <br />BUA 7040001609 <br />9/1/2024 <br />9/1/2025 <br />EOa aBc deDntSINGLE L€MIT <br />$ 1 000,000 <br />✓ <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />✓ <br />HIRED NON -OWNED <br />AUTOS ONLY ✓ AUTOS ONLY <br />PROPERTYDAMAGE <br />Per accident <br />$ <br />$ <br />✓ <br />Comp/Coll Dei iuct ble $1,000 <br />A <br />✓ <br />UMBRELLA LIAR <br />/ <br />OCCUR <br />✓ <br />✓ <br />CUE 7040002176 <br />9/1/2024 <br />9/1/2025 <br />EACH OCCURRENCE <br />$ 9 000 000 <br />AGGREGATE <br />S9,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DEC I ✓ RETENTION$10,000 <br />S <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y 1 N <br />ANYPROPRIETORIPARTNERIEXECUTIVE <br />OFFiCFR1MEMBER EXCLUDED? � <br />M I A <br />�/ <br />72WE0L6HIH <br />9/1/2024 <br />9/1/2025 <br />�/ STATUTE �RH <br />E.L. EACH ACCIDENT <br />$ 000 0aa <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1 000 000 <br />(Mandatory in NH) <br />If yes. describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />1 $ 1 000 000 <br />C <br />Profess'onal/Pollution Liability <br />✓ <br />C27737240601 <br />9/1/2024 <br />9/1/2025 <br />$5,000,000 Per Claimf$5,000,000 Aggregate <br />Deductible: $100,000 Each Claim incl exp <br />A <br />Equipment Leased Borrowed or Rentec <br />7039996776 <br />9/1/2024 <br />9/1/2025 <br />$125,000 Limit; $1,000 Deductible <br />A <br />Contractors Equipment - Scheduled <br />7039996776 <br />9/1/2024 <br />9/1/2025 <br />$534 309 Limit; $2 500 Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: Construction Management and Inspection Services for the Bristol Street Improvements Project (RFP No. 24-139)— Cannon # 241137 <br />**SEE ATTATCHED ADDENDUM*** <br />f)igiEallysigned APPROVED <br />Tu Tran bvT.T�a� <br />Nguyen <br />Nguyen Dale:2025.03.11 By Tu Tran Nguyen of 2:39 pm, Mar 99, 2025 <br />7 14:39:59-07'40' <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Risk Management Division <br />Attention: Danny Mai <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE � <br />Karen Smith <br />O 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />84312285 1 24-25 CL/AL/WC/UM/PL I Isabella Saldiv 1 3/11/2025 11:19:S5 AM (PDT) I Page 1 of 15 <br />