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CERTIFICATE OF LIABILITY INSURANCE F DATE(MMrDDIYYYY)
<br /> 05114/2025
<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($), 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 /> Marsh Risk&Insurance Services NAME: Jan Mitchell
<br /> CA License 40437153 A c NN Exe: 602 337 6295 � No
<br /> 633 W.Fifth Street,Suite 1200 E-MAIL
<br /> Los Angeles,CA 90071 ADDRESS: janet.k.mftchell@marsh.eom
<br /> INSURER 5 AFFORDING COVERAGE NAIC#
<br /> CN1016C0557-TKG-GAUW-25-26 ALL INSURER A: Zurich American Insurance Co 16535
<br /> INSURED The KI1:infelder Group,Inc INSURER B: American Guarantee&LIability Ins Co 26247
<br /> 770 First Avenue,Suite 400 INSURER c: -See Additional Page for Pa icl a inCarriers
<br /> San D+ego,CA 92101
<br /> INSURER D
<br /> INSURER E
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: LOS-002737505-11 REVISION NUMBER: 7
<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 7"YPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MMIDD Y MMIDD LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY GLO 6124594-04 D410112025 04101/2026 EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTEDPREMISES Ea occurrence $ 1,000,000
<br /> ME D EXP{Any one person} $ 15,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY�JF© ❑ TOO PRODUCTS-COMPIOP AGG $ 2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY BAP 6124595-04 0410112025 0410112026 EOa ate EDD SINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident)$
<br /> 9 X UMBRELLA LIAR X OCCUR SXS 6124597-04 0410112025 04101/2026 EACH OCCURRENCE $ 3,000,000
<br /> EXCESS LIAR CLAIMS MADE AGGREGATE $ 3,000,000
<br /> DED I I RETENTION$ $
<br /> A WORKERS COMPENSATION WC 6124596-04 04/01/2025 0410112026 X I STATUTE 124H
<br /> AND EMPLOYERS'LIABILITY YIN
<br /> ANYPROPRIETORIPARTNERIi-XECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICE RIMEMBEREXCLUDED? N N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> It yes,describe under
<br /> DESCREPTfON OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> C Env,Contractor Poll/Prof E&O FINPA2550033 0410112025 04101/2026 Each Claim 2,000,000
<br /> Claims-Made Policy Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,maybe attached if more space is required)
<br /> RE: On-Call material testing and special inspection services for the City's Public Work Agency,Agreement No.A2021-121-02. RFP#20-111 City of Santa Ana,its officers,agents,employees,volunteers and
<br /> representatives are included as Additional Insured where required by written contract Oth respects to the General Liability and Automobile Uabil Ity policies. General Liability policy evidenced herein Is Primary and
<br /> Non-Contributory to other insurance available to Additional Insured,but only in accordance Wlh the policy's provisions. A Waiver of Subrogation is granted in favor of Certificate Holder where required by written
<br /> contract.
<br /> Tu Tra n Digitally signed by
<br /> Date:2 Tu Tran Nguyen APPROVED
<br /> Date:2025.05.14
<br /> Nguyen 14:44:41-07'00'
<br /> By Tu Tran Nguyen at 2:44 pm,May 14,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Attention:Public Woft Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> CIPIDesign Engineering ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92701 M-36
<br /> AUTHORIZED REPRESENTATIVE
<br /> O 1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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