SULLY-MILLER CONTRACTING COMPANY (BRISTOL ST. IMPROVEMENTS FROM WARNER AVE. TO ST. ANDREW PL.)

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Page 1 of 2 A`CO 03/11/2025RV CERTIFICATE OF LIABILITY INSURANCE DATE{M /2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT W W Certificate NAME: Center Willie Towers Watson Northeast, Inc. PHONE ],_g77^945-737$ FAX 1-888-467-237$ c/o 26 Century Blvd AIC No; P.O. Box 305191 E•MRE35: certificates@wtwao.com ADD Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAIL0 INSURERA: Liberty Mutual Eire Insurance Company 23035 INSURED INSURERS: Berkshire Hathaway Specialty Insurance Com 22276 Sully-Miller Contraoting Company 135 s, state College Blvd., Suite 400 INSURERC: Brea, CA 92921 INSURER D: INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER:W38104652 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN$R ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD NYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any une nrson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO ❑ LOC JECT PRODUCTS-COMPIOP AGO $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ee accldart ANY AUTO BODILY INJURY{Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY[NJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE nt AUTOS ONLY AUTOS ONLY Per accide $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 X EXCESS LIAB CLAIMS-MADE Y Y TL2-631-510040-B25 04/01/2025 04/01/2026 AGGREGATE $ 3,000,000 X DED RETENTION$0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I I ER ANYPROFFI EORIMEMB RFXCLU E07ECUTIVE ❑ NIA E.L.EACH ACCIDENT $ {Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below I I I I E.L.DISEASE-POLICY LIMIT $ B 1st Excess Liability Y Y 47-x86-302408-10 04/01/2025 04/01/2026 Each Occurrence $5,000,000 Aggregate ryry $5,D00,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) For Division Branch: 10340704 ey Tu Trarr Nguyen atg:244am,Apr07,2025 Excess policy is follow form over the General Liability, Automobile, and Employers Liability. Project No. 11-6741 Bristol Street Improvements from Warner Ave to St. Andrew Place and Project 16--6499 Bristol Street (Phase 4) Water Main. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana - City Hall Rosa Annex Attn: City Clerk AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza �tGLWf Santa Ana, CA 92701 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR m: 27418627 SATcl: 3870056