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AC"R"® CERTIFICATE OF LIABILITY INSURANCE r ATE(MM/ DfY )
<br /> 25
<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 /> McGriff Insurance Services LLC NAME: Lauren Ma er
<br /> 2200 N. Commerce Parkway PUVC.HONNo_E . 954-385-6022 ac No):866-802-8684
<br /> Suite 200 ADDRESS: lauren.ma of mC riff.com
<br /> Weston FL 33326 INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Berkshire Hathaway Homestate Ins Co 20044
<br /> INSURED 132SAFEBLLC INSURER B:Everest Indemnity Insurance Company 10851
<br /> Interwest Consulting Group, Inc.444 N Cleveland Ave; INSURER C:Everest Premier Insurance Company 16045
<br /> Loveland CO 80538 INSURERD:Bridgeway Insurance Company 12489
<br /> INSURER E:Great American E&S Insurance Company 37532
<br /> INSURER F: Great American E&S Insurance Company 37532
<br /> COVERAGES CERTIFICATE NUMBER:2145910428 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 /> TYPE OF INSURANCE
<br /> LTR POLICY NUMBER MMIDDIYYYY MM/DD/YYYY LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY Y Y CF3GL00415241 10/3/2024 10/3/2025 EACH OCCURRENCE S1,000,000
<br /> CLAIMS-MADE M OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrence 5300,000
<br /> X 10,000 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 /> X POLICY[K] PRO- LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY Y Y CF3CA00337241 10/3/2024 10/3/2025 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY Per accident
<br /> AUTOS ONLY AUTOS ( ) $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident S
<br /> Excess perace Iagg $1,000,000
<br /> D UMBRELLA LIAB X OCCUR Y Y 8EA7XL000207903 10/3/2024 10/3/2025 EACH OCCURRENCE $10,000,000
<br /> E 011170903 10/3/2024 10/3/2025
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED I X I RETENTION$ $
<br /> A WORKERS COMPENSATION Y SAWC666825 5/12/2025 5112/2026 X STATUTE ORH
<br /> AND EMPLOYERS'LIABILITY Y/N
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBER EXCLUDED?
<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 /> F Professional Liability TER5325879 10/3/2024 1013/2025 Each Claim/Aggregate 10,000,000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Excess policy#140002058 effective 10/03/2024-10/03/2025-QBE Ins Corp NAIC#39217-Limits-$5,000,000 part of$10,000,000 Excess of$5,000,000.
<br /> Crime coverage—Federal Insurance Company,NAIC 20281-Policy#J06767825 effective 10/3/24-10/3/25;Limit$1,000,000 DED$10,000.Technology Errors
<br /> &Omissions and Cyber Coverage-Coalition Insurance Company NAIC#29530-Policy#C4LRS025767CYBER effective 10/3124-1013/25.Each Claim/AGG
<br /> $3,000,000 DED$100,000.
<br /> RE:RFP#23-142-On Call Environmental and Planning Services.
<br /> The City of Santa Ana,its officers,officials,employees,and volunteers are additional insureds with respects to general and automobile liability,with a written
<br /> contract.Waiver of Subrogation applies to general and automobile liability and workers compensation in favor of the additional insureds,with a written contract.
<br /> Coverage is primary and non-contributory for the additional insureds.Notice of Cancellation is 30 days,except 10 days for non-payment.
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Tran Nguyen at 2:36 pm,May 27,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana Digitally igned by Tu Tran ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> s
<br /> Planning and Building Agency ru Tran Nguyen
<br /> 20 Civic Center Plaza N u en Date:zo25.05.z7 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702 9 Y 74:37:16-bToO' 4Jt�
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<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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