|
A�/ " CERTIFICATE OF LIABILITY INSURANCE pAT3I2712025YY)
<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(les)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: Jennifer Balek
<br /> Arthur J. Gallagher Risk Management Services, LLC PHONE
<br /> IH°No Ex : 8053673337 FArAX No;818-316-0990
<br /> 21820 Burbank Blvd Ste 301 E-MAIL
<br /> Woodland Hills CA 91367 ADDRESS: Jennifer Balekpajg.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> License#:0069293 INSURERA:National Union Fire Insurance Company of Pittsburg19445
<br /> INSURED RMACOMP-01 INSURER B:Travelers Property Casualty Company of America 25674
<br /> RMA Group
<br /> 12130 Santa Margarita Ct INSURER C:
<br /> Rancho Cucamonga CA 91730 INSURERD:
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:924621737 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 INSD WVDR POLICY NUMBER MMIDDPOLICY EFF MMIDDPOLICY EXP LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 4611548 31112025 3/1/2026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE JJ OCCUR DAMAGE To RENTED
<br /> PREMISES Ea occunence $300,000
<br /> MED EXP(Any one person) $25,000
<br /> PERSONAL BADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY X E Q 1XI LOC PRODUCTS-COMP/OP AGG $4,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY Y Y 7093502 3/1/2025 311/2026 COMBWEDSINGLELIMIT $2,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED IX
<br /> NON-OWNED I PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> B X UMBRELLA LIAB X OCCUR CUP-8033556A 3/1/2025 311/2026 EACH OCCURRENCE $11,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $11,000,000
<br /> QED X I RETENTION$1 n nnn $
<br /> A WORKERS COMPENSATION Y 14122658 31112025 3/112026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPR0PRIETORIPARTNFF0FXFCUTIVE E,L.EACH ACCIDENT $2,000,OCo
<br /> OFFICERIMEMBEREXCLUDED? Y NIA
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $2,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,004,000
<br /> :E
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: Project Name:22-1388 ARPA Neighborhood Street Lights; Project Number:00-241639-0
<br /> City of Santa Ana is included as Additional Insured as respects General Liability and Auto Liability policies,pursuant to and subject to the policy's terms,
<br /> definitions,conditions and exclusions.The insurance provided in the General Liability and Auto Liability policies is primary and any other insurance shall be
<br /> excess only,and not contributing.Waiver of Subrogation applies to Additional Insureds,as respects General Liability,Auto Liability and Workers Compensation
<br /> policies,pursuant to and subject to the policy's terms,definitions,conditions and exclusions.Written notice shall be provided at least ten(10)days in advance
<br /> of cancellation for non-payment of premium and thirty(30)days in advance for any other cancellation or policy Change,
<br /> CERTIFICATE HOLDER A it"IPMU CANCELLATION
<br /> 8y Tlr Tran Nguyen of 2:23 prrr,May 19,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> DgaanyAe-d THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> TU Tran byT.T1- ACCORDANCE WITH THE POLICY PROVISIONS,
<br /> City of Santa Ana N9°y-
<br /> N g u ye n Wle:2025 0519
<br /> 20 Civic Center Plaza, Ross Annex 142431 Tffl AUTHORIZED REPRESENTATIVE
<br /> Santa Ana 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 />
|