Laserfiche WebLink
,�co O® CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDlYYYY) <br /> 41412025 <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 CONTANAME: KATO DAWOOD <br /> DAWOOD INSURANCE AGENCY PHONNo.E Ext 949 417-0204 FAX No: 714)842-9791 <br /> 18800 Delaware St#304 AbDREss: kato dawoodinsurance.com <br /> Huntington Beach,CA 92648 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A: ADMIRAL INSURANCE COMPANY 24856 <br /> INSURED INSURER B: <br /> Pyramid Group International, Inc. INSURERC: <br /> 25771 Rapid Falls Road INSURER D: <br /> Laguna Hills, CA 92653 INSURERE: <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 ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE 1Nqn vlrvn POLICY NUMBER MMIDDIYYYY) [MM/DDIYYYYl LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 <br /> X CLAIMS-MADE OCCUR DAMAGE TO RENTED <br /> PREMISES Ea occurrence $ 50000 <br /> MED EXP(Any one person) $ 6,000 <br /> A X x FEI-ECC-28399-04 3/22/2025 3/22/2026 PERSONAL&ADV INJURY S 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 <br /> POLICY PRO- <br /> JECT LOC PRODUCTS-COMPIOPAGG S 2,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) S <br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $ <br /> DIED i I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE I ER <br /> ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? ❑ NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> PROFESSIONAL LIABILITY Occurrence 2,000,000A re ate 2,000,000 <br /> X x A FEI-ECC-28399-04 3/22r2025 3122r2026 99 9 <br /> Claim Expense 1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> This Certificate of Insurance names: City, its City Council,officers,employees,agents and volunteers are named as additional <br /> insureds. Primary/Non-Contributory Endorsement form must be provided in addition to the Certificate of Insurance for General <br /> Liability included and it will follow upon the issuance of the policy. Diginil,,19,M <br /> Tu Tran bYTu'r— <br /> u en N9uYe�N APPROVED <br /> Nguyen e,�e <br /> o904O1-0J'Ip' <br /> By Tu Tian Nguyen at 8:54 am,Apr 07, 2025 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> ADDITIONAL INSURED THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> CITY OF SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ATT:PUBLIC WORKS AGENCY,SUZANNE FURJANIC <br /> AUTHORIZED REPRESENTATIVE <br /> 20 CIVIC CENTER PLAZA,M-11 <br /> SANTA ANA,CA 92701 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />