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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br /> 9/9/2025
<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 /> AssuredPartners Design Professionals Insurance Services, LLC NAME: Anni Owens
<br /> PHONE - FAX
<br /> 3697 Mt. Diablo Blvd Suite 230 Arc No EXt: 510-272-1465 A,c No):
<br /> Lafayette CA 94549 ADDRESS: CertsDesignPro@AssuredPartners.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:6003745 INSURERA: BERKLEY INSURANCE COMPANY 32603
<br /> INSURED MIGiNCO-01 INSURER B:Travelers Property Casualty Company of America 25674
<br /> MIG, Inc. INSURERC:The Travelers Indemnit Com an of Connecticut 25682
<br /> Moore lacofano Goltsman, Inc. y
<br /> 800 Hearst Ave INSURER D: National Indemnity CompanL.. 20087
<br /> Berkeley CA 94710 INSURERE:Twin City Fire Insurance Company 29459
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1591360611 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 I TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER MWDD MMIDDIYYY LIMITS
<br /> 8 X COMMERCIAL GENERAL LIABILITY Y Y 680IH899998 8/3112025 8/31/2026 EACH OCCURRENCE 51,000,000
<br /> CLAIMS-MARE X DAMAGE TO RENTED OCCUR PRFM6ES Ea occurrence 31,000,000
<br /> X Contractual Liab MFD FXP(Any one person) S 10,000
<br /> Included PERSONAL&ADV INJURY S 1,000,000
<br /> GEN•LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY JECT F� LOC PRODUCTS-COMPIOPAGG $2,000,000
<br /> OTHER: S
<br /> C AUTOMOBILE LIABILITY Y Y BAOS579947 8/31/2025 8/31/2026 COMBINED SINGLE LIMIT S 1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) S
<br /> OWNED SCHEDULED BODILY INJURY Per accident $
<br /> AUTOS ONLY AUTOS ( 1
<br /> X HIRED X NON-OWNED PROPERDAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accidTYentl $
<br /> 5
<br /> B X UMBRELLA LIAB X OCCUR Y Y CUPOH758762 8/3112025 8/31/2026 EACH OCCURRENCE S 10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED I X I RETENTIONS S
<br /> B WORKERS COMPENSATION Y U821-553909 8/31/2025 8/31/2026 X I PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE Eft
<br /> ANYPROPRIETOPJPARTNERIEXECl1TNE E.L.EACH ACCIDENT S 1,000,000
<br /> OFFICER/MEMHEREXCLUDED? � N f A _
<br /> (Mandatory in NHI E.L.DISEASE-EA EMPLOYEE S 1,000,000
<br /> If yes,descrihe under
<br /> DESCRIPTION OF OPERATIONS below E-L.DISEASE-POLICY LIMIT S 1,000,000
<br /> A Professional Llab&ContuPoll AEC909023107 8/31/2025 8/31'2026 PerClaim!$5,000,000 $5,000,0001Aggr
<br /> D DroneUability 9004014 8/3112025 8/3112026 Limit $1,000,000
<br /> E CyberLiability 57MB035552025 8/3112025 8/31/2026 L'md $1.000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The following policies are included in the underlying schedule of insurance for umbrella/excess liability:General Liability/Auto Liability/Employers
<br /> Liability/Employee Benefits Liability,
<br /> Project: RFP#23-010, Project:California Environmental Quality Act(CEQA).
<br /> City of Santa Ana,its officers,officials,employees,and volunteers are named as an additional insured as respects general liability and auto liability as required
<br /> per written contract. General Liability is Primary/Non-Contributory per policy farm wording. Insurance coverage includes waiver of subrogation per the attached
<br /> endorsement(s).
<br /> APPROVED
<br /> 8y Tu Tran Nguyen of 8:32 am,Sep 10, 21?25
<br /> CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation
<br /> Tu Tra n Xglta[ly signed lr SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Tu Tran Nguyen THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> oare:zazs oa.ta ACCORDANCE WITH THE POLICY PROVISIONS,
<br /> City of Santa Ana 'N9U�/2'i'log3s:s2.o7•ao'
<br /> Planning and Building Agency
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> C)1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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