|
AC40RLP CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />07/07/2025
<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
<br />CONTACT Certificate Department
<br />Newfront Insurance Services, LLC
<br />A/CONNo, Ext : (415) 754-3635 FAX No):
<br />E-MAIL q ADDRESS: techcertre uest newfront.com
<br />777 Mariners Island Blvd
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />Suite 250
<br />INSURERA: Berkley National Insurance Company
<br />38911
<br />San Mateo CA 94404
<br />INSURED
<br />INSURER B : Riverport Insurance Company
<br />36684
<br />INSURERC: Steadfast Insurance Company
<br />26387
<br />Governmentjobs.com, Inc.
<br />INSURER D
<br />NEOGOV
<br />INSURER E
<br />2120 Park PI, Suite 100
<br />INSURER F :
<br />ElSegundo CA 90245
<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,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
<br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE � OCCUR
<br />DAMAGE SES (E. occuTO rrDence)$
<br />PREM
<br />1,000,000
<br />MED EXP (Any one person)
<br />$ 15,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />A
<br />X
<br />X
<br />TCP7011473
<br />09/25/2024
<br />09/25/2025
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 3,000,000
<br />%<
<br />POLICY D PRO �
<br />JECT LOC
<br />PRODUCTS - COMP/OPAGG
<br />$ 3,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />X
<br />X
<br />TCA7011474
<br />09/25/2024
<br />09/25/2025
<br />BODILY INJURY (Per accident)
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />rx
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />$
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />$CLAIMS
<br />AGGREGATE
<br />$
<br />HB
<br />-MADE
<br />TENTION $
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y
<br />OFFICE R/MEMBEREXCLU EXCLUDED?❑
<br />(Mandatory in NH)
<br />N/A
<br />X
<br />TWC7011475
<br />09/25/2024
<br />09/25/2025
<br />X PER OTH-
<br />STATUTE ER
<br />E.LEACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />Occurrence
<br />$5,000,000
<br />C
<br />Technology including Cyber
<br />Liability (Claims -Ms -Made)
<br />EOC 6219893 - 05
<br />09/25/2024
<br />09/25/2025
<br />A re ate
<br />Aggregate
<br />$5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD
<br />101, Additional Remarks Schedule, maybe attached if more space is required)
<br />RE: All Operations of the Named Insured.
<br />The City of Santa Ana, its Officers, Officials, Employees and Volunteers are to be covered are included as an additional insureds as respects to General Liability
<br />and Auto Liability, but only to the extent required by written
<br />contract or written agreement. General Liability policy is Primary and Non -Contributory, but only to
<br />the extent required by written contract or agreement. Waiver of Subrogation applies to General Liability, Auto Liability and Workers Compensation, but only to the
<br />extent required by written contract or agreement.
<br />Tu Tran Digitally signed by
<br />Tu Tran Nguyen
<br />Date:2025.07.08 APPROVED
<br />Nguyen 08:22:55-0700'
<br />CERTIFICATE HOLDER
<br />CANCELLATION By Tu Tran Nguyen at 8:22 am, Jul 08, 2025
<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
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZ ESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana,
<br />CA 92701
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|