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�.....„1 VIDOSAM-01 JCHRISTIANSON
<br /> 4C RL CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 1/3/2025
<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 CONTACT
<br /> NAME:
<br /> HUB International Insurance Services Inc. PHONE
<br /> 4695 MacArthur Court (A/C,No,Ext):(949) 553-9800 1
<br /> FAX
<br /> No):
<br /> Suite#600 E-MAIL
<br /> ADDRESS:
<br /> Newport Beach,CA 92660
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:The Travelers Indemnity Company of America 25666
<br /> INSURED INSURER B:AmTrUSt Insurance Company 15954
<br /> Vido Samarzich,Inc. INSURER C:Navigators Specialty Insurance Company 36056
<br /> 6829 Billings PI INSURER D:
<br /> Rancho Cucamonga,CA 91701--4923
<br /> INSURER E:
<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 /> INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP
<br /> INSD WVD (MMLDD/YYYYJ (MMLDD/Y YYL LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR X X 4T-CO-A7193762-TCT-25 1/1/2025 1/1/2026 DAMAGE TO RENTED 300,000
<br /> PREMISES(Ea occurrence) $
<br /> MED EXP(Any one person) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO-
<br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER:
<br /> A $
<br /> AUTOMOBILE LIABILITY Ea aBINEDISINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO X X BA-A7193608-25-2S-G 1/1/2025 1/1/2026 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 /> $
<br /> A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> EXCESS LIAR CLAIMS-MADE CUP-A7193842-25-2S 1/1/2025 1/1/2026 AGGREGATE $ 5,000,000
<br /> DED X I RETENTION$ 10,000
<br /> $
<br /> B WORKERS COMPENSATION AND EMPLO ERS'LIABILITY
<br /> X STATUTE I OTH-
<br /> ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X CTP1003323 111/2025 1/1/2026 E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? Y N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE!
<br /> $ 1,000000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> C Umbrella Liability LA25EXCZOK6PLIC 1/1/2025 1/1/2026 Each Occ./Agg. 3,000,000
<br /> A Leased/Rented Equip. 4T-CO-A7193762-TCT-25 1/1/2025 1/1/2026 Limit 125,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: Project#22-1342;10th Street&Flower Improvements. glaipwv/auaiwv/wcwv
<br /> City of Santa Ana,its officers,officials,employees,and volunteers are included as Additional Insureds as respects General Liability and Auto Liability per
<br /> attached endorsements.
<br /> This insurance shall apply as Primary and Non-Contributory per attached endorsement.
<br /> Waiver of Subrogation for General Liability,Auto Liability and Workers'Compensation:See Attached Endorsements.
<br /> CERTIFICATE HOLDER RukManag`m`niei`i. CANCELLATION
<br /> It
<br /> o
<br /> aa.r ; Kiw.3i.a.e
<br /> e,k Manager SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> ``ro"- THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division,4th Floor
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE
<br /> 004-#46-40,i-___
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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