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•��'�o CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) <br /> Arcl#; 2524922 112112 1I21l2026 <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.If <br /> SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this <br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> CONTACT <br /> PRODUCER NAME: <br /> USI Insurance Services,LLC PHONE 84A-290-490810,No, FAX <br /> 2502 N Rocky Point Drive E-MAIL. xt Arc No <br /> L <br /> Tampa,FL 33607 ADDRESS: bbsicerts@locktonaffinity.com <br /> INSURERS AFFORDING COVERAGE NAIC 4 <br /> INSURER A: Ace American Insurance Company 22667 <br /> INSURED INSURER B <br /> GEMS ENVIRONMENTAL MANAGEMENT SERVICES,INC. <br /> 1120 WILLOW PASS CT, IINSURER C: <br /> CONCORD,CA 94520 INSURER D: <br /> INSURER E: <br /> I NSURER 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 /> EXCLUSIONSAND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INS, TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM PDIYYY MM�OPOLICY EFF NYYp LIMITS <br /> LTR <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAM GE TO RENTED <br /> CLAIMS-MADE1:1 OCCUR PREMISES Ea occurrence $ <br /> MED ECP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY❑ PRO LOG PRODUCTS-COMP/OP AGG $ <br /> JECT <br /> OTHER: <br /> AUTOMOBILE LIABILITY (Ea aaciden SINGLE LIMIT $ <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Peraccidenf <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DIED I I RETENTION$ $ <br /> WORKERS COMPENSATION X STATUTE ERH <br /> AND EMPLOYERS'LIABILITY Y I N <br /> ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 2,000,000 <br /> A OFFICERIMEMBFR EXCLUDED? NIA X C58906347 61112025 6/1/2026 <br /> E.L.DISEASE-EA EMPLOYE $ 2,000,000 <br /> (Mandatory in NH) <br /> If as,describe under E.L.DISEASE-POLICY LIMIT $ 2,000,000 <br /> DESCRIPTION OF OPERATIONS below <br /> i <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace is required) <br /> Policy State=CA <br /> Waiver of Subrogation in favor of certificate holder when required by written contract <br /> 24-6053 OCFA Fire Station 74 Fuel Station Replacement <br /> [APPROVED Tu Tran Nguyen of 3r29 prn Feb 03,24 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> CITY OF SANTA ANA PUBLIC WORKS AGENCY HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br /> 20 Civic Center Plaza,P.O.Box 198I18 N ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Santa Ana,CA 92702 <br /> AUTHORIZED REPRESENTATIVE p <br /> t;X t-act-.-C.l!�• l�[�.�2.J't.,d'LI�.=f�.fl.�� <br /> ©1988-201S ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD <br />