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A��" CERTIFICATE OF LIABILITY INSURANCE DAT31271202
<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 /> NAME: Jennifer Balek
<br /> Arthur J. Gallagher Risk Management Services, LLC PHONE FAX
<br /> 21820 Burbank Blvd Ste 301 Ext: 8053673337 Arc No.818-316-0990
<br /> IL
<br /> Woodland Hills CA 91367 ADDARESS: Jennifer Balek a' .com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> License#:OD69293 INSURER A: National Union Fire Insurance Company of Pittsburg19445
<br /> INSURED RMACOMP41 INSURER B: Travelers Property Casualty Company of America 25674
<br /> RMA Group
<br /> 12130 Santa Margarita Ct INSURERC:
<br /> Rancho Cucamonga CA 91730 INSURER[):
<br /> INSURER E:
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER:855517687 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
<br /> LTR POLICYNUMBER MMIDDIYYYY MM1DVfYYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 4611548 3/1/2025 3/112026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE � OCCUR OHMAGE (RENTED
<br /> PREMISES Ea occurrence) $340,000
<br /> MED EXP(Any one person) $25,000
<br /> PERSONAL&ADV INJURY $2.000,000
<br /> GENT AGGREGATE LIMIT APPLI ES PER: GENERAL AGGREGATE $4,000,000
<br /> PRO-
<br /> POLICY JECT 1XI LOG PRODUCTS-COMP/OP AGG $4,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY Y Y 7093502 311/2025 3/1/2026 EOa BINC tLD SINGLE LIMIT $2,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per $
<br /> AUTOS ONLY AUTOS ( )
<br /> HIRED Xr NON-OWNED PROPERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> 6 X UMBRELLA LIAB X OCCUR CUP-B033556A 3/112025 3/1/2026 EACHOCCURRENCE $11,000.000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $11,000,000
<br /> ❑ED I X I RETENTION$in nnn $
<br /> A WORKERS COMPENSATION Y 14122658 3/1/2025 311/2026 X STATUTE ERH
<br /> AND EMPLOYERS'LIABILITY Y 1 N
<br /> ANYPROPRIETORlPARTNEPJEXECUTIVE E.L.EACH ACCIDENT $2,000.000
<br /> OFFICERIMEMBEREXCLUDED? Y I 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 $2,000,000
<br /> T_
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: Project Number:00-240285-0 1 Project Name:Construction Inspection&Testing Services-18-6491 Well No.29 Improvements
<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 AV V ED CANCELLATION
<br /> ay Tu Tran Nguyen at 2:20 pm,May 99,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> DigitAysigmd THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Tu Tran byT�T,a� ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana Nguyen
<br /> 20 Civic Center Plaza; Ross Annex Nguyen Date:zp25.o5.19
<br /> ra:zo�sr Tap• REPRESENTATIVE
<br /> Santa Ana, CA 92701 AUTHORIZED 1
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br /> THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE
<br />
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