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A� CER`TIFICATE OF LIABILITY INSURANCE DATE(MM/DDlYYYY) <br /> 10/08/2024 <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 /> Premier Service Insurance Agency NAME, MANAL SULLIVAN _ <br /> 501 N.Brookhurst St.Ste#150 PHONE <br /> aC NNNE 714-533-8600 _ AX No):714-533_-86.00 — <br /> Anaheim CA 92801 E-MAIL EgL— <br /> ADD REss:PSIA.MANAL@YAHOO.COM <br /> INSURER(S)AFFORDING COVERAGE NA_I_C# _ <br /> INSURER A:SCOTTSDALE INSURANCE COMPANY 41297 <br /> INSURED MAJ ENGINEERING INSURER <br /> 14608 FAWN PATH RD. INSURERC: <br /> CHINO CA 91709 INSURER D: ' <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 ADDLiSUBR POLICY EFF POLICY EXP -- -- <br /> LTR TYPE OF INSURANCE INSD I WVD POLICY NUMBER MMIDDIYYYY)I(MMIDDIYYYYII LIMITS <br /> A t/ COMMERCIAL GENERAL LIABILITY 1 , <br /> 11 EACH OCCURRENCE l$2,000,000 <br /> It CLAIMS-MADE 1-1 OCCUR VHPUD-T 8/09/2024 08/09 -DAMAGE To RENTCDl2025 PREMISES Ea occurrence) $100,000 <br /> - MED EXP(Any one person) $5,000 <br /> _ PERSONAL&ADVINJURY $�I,000,000 <br /> GFN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 <br /> POLICY❑PET ❑LOC PRODUCTS-COMPIOPAGG $2,000,000 <br /> OTHER. $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY P _ <br /> AUTOS ONLY _ AUTOS (Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY Per accident $ <br /> UMBRELLA LIAR OCCUR ! EACH OCCURRENCE $ <br /> tEXCESS LIAB CLAIMS-MADEP AGGREGATE _ $ <br /> L RETENTIONS $ _ <br /> WORKERS COMPENSATION ' OT <br /> AND EMPLOYERS'LIABILITY Y/N I I PER <br /> EERH <br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ _ <br /> OFFICERIMEMBEREXCLUDED? ❑ NIA _ <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under -- -- <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> 71 <br /> irdHI <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> The City of Santa Ana,its City Council,its officers,officials,employees,agents and volunteers are to be covered as additional insured <br /> ith respect to liability arising out of work or operations performed by or on behalf of the contractor,including materials,parts,equipment, <br /> and personnel furnished in connection with such work or operations. <br /> WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO THE CITY OF SANTA ANA. <br /> WAIVER OF SUBROGATION IS INCLUDED. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> AND ADDITIONAL INSURED: THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> City of Santa Ana <br /> 20 Civic Center Plaza-Ross Annex AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92702 MANAL SULLIVAN <br /> _ Manal Sullivan <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD — <br /> Produced using Forms Boss Web software.www.Formsooss.com;y Impressive Publishing 800.208.1977 APPROVED <br /> [By Luisa Najera at 2:27 pm,Jan 09,2025 <br />