Laserfiche WebLink
76/25/2025 <br /> E(MM/DDYYY) <br /> A�" CERTIFICATE OF LIABILITY INSURANCE /Y <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 /> Risk Strategies Company PHONE NAMESherr Young <br /> FAX <br /> 2040 Main Street, Suite 450 A/c No Ext: 949-242-9237 A/c No): <br /> Irvine, CA 92614 ADDRESS: syoung@risk-strategies.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> www.risk-strategies.com CA DOI License No.OF06675 INSURERA: Hartford Underwriters Insurance Company 30104 <br /> INSURED INSURERB: Hartford Casualty Insurance Company 29424 <br /> Phase II Systems INSURERC: Starr Surplus Lines Insurance Company 13604 <br /> dba: PARS <br /> 4350 Von Karman Ave., Ste 100 INSURERD: <br /> Newport Beach CA 92660 INSURERE: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 85926200 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 SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICYNUMBER MM/DD MM/DD <br /> A / COMMERCIAL GENERAL LIABILITY ✓ 72SBABLVTP 5/8/2025 5/8/2026 EACH OCCURRENCE $2,000,000 <br /> AMAIE To RENTED <br /> CLAIMS-MADE Iv] OCCUR PREM SES(E.occurrence) <br /> ccurrrence) $1,000,000 <br /> MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $4,000,000 <br /> POLICY ✓� ECT LOC PRODUCTS-COMP/OPAGG $4,000,000 <br /> 1� PRO- <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY ✓ 72SBABLVTP 5/8/2025 5/8/2026 EOa acccideDtSINGLE LIMIT $2,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident <br /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> B WORKERS COMPENSATION 72WECAY9CJZ 7/1/2025 7/1/2026 STATUTE OERH <br /> AND EMPLOYERS'LIABILITY Y/N <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? ❑ N/A <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 /> C Professional Liability 1000635549241 7/30/2024 7/30/2025 Per Claim:$3,000,000 <br /> Aggregate:$3,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> igred <br /> Projects as on file with the insured including but not limited to Agreement for Administrative Services,A-2020-119, Tu Tran TDuTralnyNguye by <br /> City of Santa Ana PARS 3121 Part-Time Social Security Alternative Retirement Plan. Date:2025.07.08 <br /> The City of Santa Ana, its officials,employees and volunteers are named as additional insureds on the general liability policy, Nguyen 10:51:20-07'00' <br /> including the non-owned and hired auto liability.General Liability policy is primary and non-contributory. <br /> The above policies contain a 30-day notice provision for non-renewal and cancellation, 10-day notice for non-payment of premium. <br /> APPROVED <br /> CERTIFICATE HOLDER CANCELLATION By TO Tran Nguyen at 10:50 am,Jul08,2025 <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 /> Attention: Rosie Perez ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza M-17 <br /> Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE <br /> RSC Insurance Brokerage <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> 85926200 125-26 CA GL-HNOA-WC, 24-25 PL Sherry Young 16/25/2025 9:41:22 AM (PDT) I Page 1 of 10 <br />