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Ac© CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDDIYYYY) <br /> 05/06/2025 <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 NONTACT <br /> AME; Automatic Data Processing Insurance Agency, Inc. <br /> Automatic Data Processing Insurance Agency, Inc. Lrc0NN Ext: 1-800-524-7024 Fu C No <br /> E-MAIL <br /> ADDRESS: <br /> 1 Adp Boulevard INSURER(S)AFFORDING COVERAGE NAIC# <br /> Roseland NJ 07068 INSURER A: State Compensator Insurance Fund 35076 <br /> INSURED BNS Construction INSURER B: <br /> INSURER C: <br /> 18633 Topharn St Apt 222 INSURER D: <br /> INSURER E: <br /> Tarzana CA 91335 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 4296255 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 INSD WVD POLICY NUMBER. MMIDDfYYYY) (MWDDffYYYI LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE ❑OCCUR PREMISES Ea occurrence $ <br /> MED EXP(Any one person) S <br /> PERSONAL&ADV INJURY 5 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 <br /> POLICY a JECT PRO ❑ LOC PRODUCTS-COMPIOP AGG S <br /> OTHER: S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S <br /> Ea amidenl <br /> ANY AUTO BODILY INJURY(Per person) 5 <br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Par accident) S <br /> HIRED NON-OWNED PROPERTY DAMAGE S <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR F1 CLAIMS-MADE AGGREGATE $ <br /> DIED I I RETENTION 5 $ <br /> WORKERS COMPENSATION PEER <br /> EMPLOYERS'LIABILITY YIN 1 STATUTE ER <br /> ANY PROPRIETOWPARTNEPJEXECUTIVE E.L.EACH ACCIDENT <br /> A OFFICEWMEMBEREXCLUDED? �Y NSA Y 9259633-2024 08123J2024 08/2312025 <br /> (Mandatory in NH) E.L.DISEASE-FAEfVIPLOYEE 5 4,000,000 <br /> If yes,describe Lnder <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5 1.,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 161,Additional Remarks Schedule,may be attached if more space is required) <br /> This certificate has a blanket Waiver of Subrogation for the following states):CA <br /> Job Locations: ,CA <br /> APPROVED <br /> By Tu Tran Nguyen at 8:23 am,May 12,2025 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City of Santa Ana Public Works Agency ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza <br /> AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92702 �tm _W) <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />