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CERTIFICATE OF LIABILITY INSURANCE r
<br /> ATE M IDDIYY'�','
<br /> 025
<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(jes)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: AnnlOwens
<br /> AssuredPartners Design Professionals Insurance Services, LLC PHONE 510-272-1465 FAX
<br /> 3697 Mt. Diablo Blvd., Suite 230 Arc No:
<br /> Lafayette CA 94549 ADDRIESS: CertsDesi g nPro AssuredPartners,cam
<br /> INSURERS AFFORDING COVERAGE NAIL#
<br /> License#:6003745 INSURERA:Travelers Property Casualty Company of America 25674
<br /> INSURED ASCEENV-01 INSURER B:The Travelers Indemnity Company of Connecticut 25682
<br /> Ascent Environmental,Mall
<br /> Inc. INSURER C:BeaZle Excess and Surplus Insurance, Inc. 17520
<br /> 455 Capitol Mall Suite 300
<br /> Sacramento CA 95814-4405 INSURER D
<br /> INSURER E
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER:307979695 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 /> ILTR TYPE OF INSURANCE ANAL SUER POLWY NUMBER FOLIC YYYY POLIO YYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 6806H400124 3/15/2025 311512026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE OCCUR OHMAGE TO RENTED
<br /> PREMISES Ea occurrence S 1,000,fl00
<br /> X Contractual Liah MED EXP(Any one person) $10,000
<br /> Included PERSONAL&ADV INJURY S 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000.000
<br /> POLICY F PE
<br /> CT LOC PRODUCTS-COMPIOP AGG S 4,0D0,000
<br /> OTHER: 5
<br /> B AUTOMOBILE LIABILITY Y Y BA4R770955 3115/2025 3/15/2026 EO �CWTINES;SINGLE LIMIT g 1,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> X HIRED X NON-OWNED PROPERTYDAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident S
<br /> X NoOwned Auto S
<br /> UMBRELLALIAB OCCUR EACH OCCURRENCE 5
<br /> EXCESS UAB CLAIMS-MADE AGGREGATE 5
<br /> DED I I RETENTIONS g
<br /> A WORKERS COMPENSATION Y UB7K512607 3/15/2025 3115/2026 X STATUTE OTH
<br /> AND EMPLOYERS'LIABILITY Yf NER
<br /> ANYPROPRIETORIPARTNERYEXECUTIVE E.L.EACH ACCIDENT $1,000,0D0
<br /> OFFICERIMEMBEREXCLUDED? F N!A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,D00
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS Below E.L.DISEASE-POLICY LIMIT $1.000,000
<br /> C Professional Llal>llty D392EE250101 3/15/2025 3/15/2026 Per Claim $2,000,000
<br /> AggregateLmit $4,000.000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> The Named Insured has no company owned autos.
<br /> Insured owns no company vehicles;therefore,hiredlnon-owned auto is the maximum coverage that applies.
<br /> Project#20230169.01 -City of Santa Ana—Environmental and Planning Services On-Call
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents and volunteers are named as an additional insured as respects general liability and
<br /> auto liability as required per written contract.Insurance coverage includes waiver of subrogation per the attached endorsement(s).
<br /> APPROVED Tu Tran TranNguyly enedbyTu
<br /> Tran Nguyen
<br /> 8 Tu Tran Nguyen at 3:31 m,Apr 10 2025 Nguyen Date:37-07'00 o
<br /> Yf7 � � 15:31:37-0T00'
<br /> CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation
<br /> 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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn: Planning and Building Agency
<br /> 20 Civic Center Plaza, M-20 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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