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______,'.....,„,,, AGUI&CA-01 DCOSTA
<br /> '4�R0• CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
<br /> 4/14/2025
<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 CONTACT
<br /> NAME:
<br /> Shank Insurance Services PICONNo,Ext (833)878-2820 FAX
<br /> 122 Avenida del Mar ( ) (AM,No):(702)870-1263
<br /> Ste C MAADE- IL insurance@swartsmanning.com
<br /> DRESS: g•com
<br /> San Clemente,CA 92672-4068
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Gemini Ins Co 10833
<br /> INSURED INSURER B:AmGUARD Ins Co 42390
<br /> Aguilar&Calderon Corporation INSURER C:Praetorian Ins Co 37257
<br /> 15738 Yermo St INSURER D:Ohio Security Ins Co 24082
<br /> Whittier,CA 90603 INSURER E:Evanston Ins Co 35378
<br /> INSURER F:
<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 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD (MM/DD/YYYYI (MM/ODIYYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X]OCCUR X X VCGP031907 5/25/2024 5/25/2025 PREMISES(Ea occur ence) $ 100,000
<br /> MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER:
<br /> B AUTOMOBILE LIABILITY (EOa aBcideD()INGLE LIMIT $ 1,000,000
<br /> X ANY AUTO X X AGAU502242 5/25/2024 5/25/2025 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> AUTOS ONLY NON-OWNEDO (Pe accident DAMAGE $
<br /> $
<br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> EXCESS LIAB CLAIMS-MADE VCFX003297 5/25/2024 5/25/2025 AGGREGATE $
<br /> DED I RETENTION$ AGG $ 2,000,000
<br /> C WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X FWC0400073 5/25/2024 5/25/2025 E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? Y NIA
<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 I$ 1'000'000
<br /> D Installation Floater BM067998728 7/20/2024 5/25/2025 Per Jobsite 250,000
<br /> E Contractor Pollution CPLMOL121763 2/2/2024 5/25/2025 General Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:Project#25-6029-Sidewalk Replacement Project FY 24/25
<br /> City of Santa Ana,its officers,employees,agents and representatives are named as additional insured with respect to the General Liability where required by
<br /> written contract as per form#CG2010 07-04 on a Primary and Non-Contributory basis as per form#VE0973 04-20 and Commercial Auto per form#BA9904
<br /> 06/18.Waiver of Subrogation applies to the General Liability as per attached form#CG240412-19,Commercial Auto per form#BA9902 09/08 and Workers
<br /> Compensation as per form#WC040306 04-84.
<br /> Digitally signed
<br /> Tu Tran by Tu Nguyenn APPROVED
<br /> N
<br /> Nguyen Date:2025A4.15
<br /> oast,3 07 00 By Tu Tran Nguyen at 10:34 am,,Apr 15,2025
<br /> CERTIFICATE HOLDER CANCELLATION \
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attention:Public Works Agency,M-22
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92701 AUTHORIZED
<br /> 1
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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