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QUALFEN-02
<br />MAXU
<br />,d►16ft o CERTIFICATE OF LIABILITY INSURANCE
<br />DATE IDIYYYY)
<br />9/25I2024
<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 endorsements .
<br />PRODUCER License # OC36861
<br />CONTACT Melissa Kaiser
<br />Alliant Insurance Services, Inc.
<br />18100 Von Karman Ave 10th FI
<br />Irvine, CA 92612
<br />PHONEFAX No:
<br />AbmA,'Ess, Melissa.Kaiser@alliant.com
<br />NAIC M
<br />SURERA:M . Ha a Insura ce Co an
<br />37974
<br />Anne
<br />INSURED
<br />bat ae: t o i €
<br />38342
<br />INSURER C:Insurance Company of the West
<br />27847
<br />Quality Fence Company Inc
<br />14929 Garfield Avenue
<br />Paramount, CA 90723
<br />INSURER D :
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NIIMRFR: mcteclnM MI IRAMEO.
<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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR JZILTYPE
<br />OF INSURANCE
<br />ADDL
<br />SUER
<br />POLICY NUMBER
<br />POLICYEFF
<br />POLICYEXP
<br />10/1/2025
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />[X] OCCUR
<br />X
<br />X
<br />MGL0200745
<br />10/1/2024
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGET ERENTEDn a
<br />PREMISSCLAIMS-MADE
<br />50 ggD
<br />MED EXP (Any oneperson)
<br />$ 5,000
<br />PERSONAL&ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY X JEC"T LOC
<br />OTHER: $5,000,000 Per Project Cap
<br />GENERAL AGGREGATE
<br />2,000,000
<br />PRODUCTS -COMPA P AGO
<br />$ 2,000,000
<br />X
<br />EBL AGG
<br />S 1,000,000
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED
<br />BI accEED SINGLE LIMIT
<br />1 ggg 00g
<br />BODILY INJURY Per person)$
<br />ANYAUTO
<br />OWNED SCHEDULED
<br />AURTNES ONLY X AUTOS
<br />BA040000090849
<br />10/1/2024
<br />10N/2025
<br />BODILY INJURY Per accident
<br />$
<br />X
<br />Peiacc dent AMAGE
<br />AUTOS ONLY X AUUTOS ONLY
<br />A
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />MXL04394DO
<br />10/1/2024
<br />10/1/2025
<br />EACH OCCURRENCE
<br />$ 10,D00,000
<br />X
<br />AGGREGATE
<br />$ 10,D00,000
<br />DIED I X I RETENTION $ D
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />,ManCtory InN )EXCLUDED? Y
<br />story )
<br />Dyes, describe underOF O
<br />DESCRIPTION OF OPERATIONS below
<br />N/A
<br />X
<br />WSD 506762002
<br />10/1/2024
<br />1D/1/2025
<br />X I PER OTH-
<br />STATUTE Eft
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L.DISEABE - EA EMPLOYE
<br />11000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if mores ace is required)
<br />Job: Operations pertaining to named insured for certholder. The City of Santa Ana, its officers, empPoyees, agents and representative are additional
<br />Insureds, primary and non-contributory, waiver of subrogation applies as respects to general liability per endorsements attached; waiver of subrogation
<br />applies as respects to workers compensation per endorsement attached.
<br />City of Santa Ana - Public Works Agency
<br />Maintenance Services Division
<br />220 S. Daisy Avenue
<br />Santa Ana, CA 92703
<br />SHOULD ANY OF THE ABOVE
<br />THE EXPIRATION DATE 1
<br />ACCORDANCE WITH THE POE
<br />AUTHORIZED REPRESENTATIVE
<br />AOR MaR%aNpa unni 1
<br />REVIEWED & APPROVED BY:
<br />A.kuA
<br />Ruk Management Specialist
<br />ACORD 25 (2016103)
<br />@ 1988-2015 ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />
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