Laserfiche WebLink
Client#: 882656 VERSATERUS <br /> DATE(MM/DD/YYYY) <br /> ACORDT1,1 CERTIFICATE OF LIABILITY INSURANCE 1 6/10/2025 <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 any rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Brenda Reid <br /> NAME: <br /> Marsh & McLennan Agency LLC PHONE _ FAX <br /> A/C,No,Ext: (A/C,No): <br /> 100 Kimball Place, Suite 300 E-MAIL brenda.reid@marshmma.com <br /> Alpharetta, GA 30009 INSURER(S)AFFORDING COVERAGE NAIC# <br /> 770 476-1770 Hartford Casualty Insurance Company 29424 <br /> INSURER A: Y p Y <br /> INSURED INSURER B:Sompo International Holdings Ltd. 046709 <br /> Versaterm Public Safety US, Inc. <br /> INSURER C:Hartford Accident&Indemnity 22357 <br /> 1 N MacDonald, Suite 500 INSURERD:Scottsdale Indemnity Company 15580 <br /> Mesa, AZ 85201 INSURER E: Lloyds of London 1043444 <br /> INSURER F: Hartford Fire Insurance Co. 119682 <br /> COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 /> ADDLSUBR <br /> LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> (MM/DD/YYYY) (MM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY 2000NBB6A2E 01/01/2025 01/01/2026 EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE L*OCCUR PREMISES(ERENTED <br /> nte) $300,000 <br /> MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> PRO- <br /> POLICY JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 <br /> OTHER: $ <br /> F AUTOMOBILE LIABILITY 20UENBJ4PBK 1/01/2025 01/01/202 (CEO, cccioeD SINGLELIMIT $1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> B X UMBRELLA LIAB X OCCUR ELD30051448101 1/01/2025 01/01/2026 EACH OCCURRENCE $5000000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5 000 000 <br /> DED RETENTION$ $ <br /> C WORKERS COMPENSATION 20WEBA3VHJ 10/01/2024 10/01/2025 X STATUTE EORH <br /> AND EMPLOYERS'LIABILITY <br /> Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N] N/A <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 /> D Cyber/Professnal EKS3554139 1/01/2025 01/01/2026 $10,000,000 per claim <br /> E Cyber/Professnal TRCX25THY7 1/01/2025 01/01/2026 $10,000,000 aggregate <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are <br /> included as Additional Insured when required by written contract, agreement or permit but only with respect <br /> to the General Liability,Auto Liability and Umbrella Liability Professional Liability insurance and subject <br /> to the provisions and limitations of the policy. Waiver of subrogation applies to General Liability, <br /> Automobile Liability and Workers Compensation and Professional Liability when required by written contract, <br /> (See Attached Descript��By <br /> ROVED <br /> CERTIFICATE HOLDER Tran Nguyen at 9:17 am,Jun 12,2025 NCELLATION <br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Digitallysigned THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Risk Management Division Tu Tran byTuTran ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Nguyen <br /> 20 Civic Center Plaza 4th Floor Nguyen Date:2025.06.12 <br /> 09:17:39-07'00' <br /> Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br /> -r�,ra-R Z,'' **5 <br /> ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD <br /> #S15077523/M14678286 JJBXR <br />