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FEHR&PE-01 MICHAELA
<br /> CERTIFICATE OF LIABILITY INSURANCE DATE 4/29/20252025
<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 License#OE67768 CONTACT Andrea Michael
<br /> NAME:
<br /> IOA Insurance Services PHONE FAX
<br /> 3875 Hopyard Road Arc,No.Ext):(925)249-7958 (AIC,No):
<br /> Suite 200 EDDREMAIL ,Andrea.Michael@ioausa.com
<br /> Pleasanton,CA 94588 A
<br /> INSURERS AFFORDING COVERAGE NAIC
<br /> INSURER A:RLI Insurance Company 13056
<br /> INSURED INSURER B:Sentinel Insurance Company, Ltd 11000
<br /> 101 Pacifica
<br /> cifica
<br /> Fehr Peers INSURER C:Travelers Casualty and Surety Company of America 31194
<br /> Suite 300 INSURERD:
<br /> Irvine,CA 92618 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 /> ADDL SUBR INSR POLICY EFF POLPCY EXP
<br /> TYPE OF INSURANCE p D POLICY NUMBER MM DD D LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE ®OCCUR PSB0006683 121612024 1216/2025 DAMAGE TO RENTED 1,000,000
<br /> PREMISES Ea occurr ce $
<br /> MED EXP(Any oneperson) $ 10,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY®jEo LOC PRODUCTS-COMPIOPAGG $ 4,000,000
<br /> OTHER:
<br /> A AUTOMOBILE LIABILITY Ea cc.d.D SINGLE LIMIT $ 1,000,000
<br /> ANY AUTO PSA0002276 12/6/2024 12/612025 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED $
<br /> AUTOS ONLY AUTOS BODILY INJURY Par accident)
<br /> X HIRED �( NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> I
<br /> A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> X EXCESS LIAR CLAIMS-MADE PSE0002889 12/6/2024 12/6/2025 AGGREGATE $ 5,000,000
<br /> DED I I RETENTION$
<br /> 13 AND EMPLOYERS'LIRS ABI ITr Y f N X STATUTE OTH-
<br /> ER
<br /> ANY PROPRIETORIPARTNERfEXECUTFVE 57WEGZJ1989 511/2025 51112026 1,004,000
<br /> fFICERIMEMBER EXCLUDED? N f A
<br /> E,L.EACHAGCIDENT $
<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 5 1,000,000
<br /> C Professional Liab. 108172265 121612024 12/612025 Per Claim 5,000,000
<br /> C Professional Liab. 108172265 121612024 12/612025 Aggregate 5,000,000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> Project Number Name: OC19-STAN.001.01 Santa Ana On-Call
<br /> All Operations of the Named Insured,including the aforementioned project.
<br /> General Liability:Please see blanket Additional Insured Endorsement attached;such coverage is Primary and Non-Contributory with Waiver of Subrogation
<br /> included,as required by written contract.
<br /> Automobile Liability:Note that the Insured owns no company owned vehicles. Please see blanket Additional Insured Endorsement with Waiver of
<br /> Subrogation included,as required by written contract.
<br /> Workers'Compensation:Waiver of Subrogation is included as per attached blanket Waiver of Subrogation Endorsement,as required by written contract.
<br /> SEE ATTACHED ACORD 101
<br /> CERTIFICATE HOLDER APPR©VED CANCELLATION
<br /> By Tu Tran Nguyen at 7.25 am,Apr 30,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana AUTHORIZED REPRESENTATIVE
<br /> Attention:Public Works Agency -12
<br /> 20 Civic Center Piz,M-43 [ lI
<br /> ISanta Ana.CA 92701
<br /> ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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