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A CERTIFICATE OF LIABILITY INSURANCE Dar10/1120215YY)
<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: Yvonne Chop
<br /> Alliant Insurance Services, Inc. PHONE 949.660.5967 FAX
<br /> Ne
<br /> 18100 Von Karman, 10th Floor E-MAIL
<br /> Irvine CA 92612 ADDRESS: yGhong@alliant.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Federal Insurance Company 20281
<br /> INSURED INSURERS:Executive Risk Indemnity Inc 35181
<br /> Macro-Z-Technology Company 841 E Washington Ave. INSURER c:Allied World National Assuranc 10690
<br /> Santa Ana CA 92701 INSURERD:Berkley Assurance Company 39462
<br /> INSURER E:Homesite Insurance Company 17221
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1069241870 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 /> IEXP
<br /> LTR ADDL TYPE OF INSURANCE INSD SWVD UER POLICY NUMBER MWDDIYYYY MMIDDPOLICY EFFYIYYYY LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY Y Y 54309459-03 10/1/2025 10/1/2026 EACH OCCURRENCE $1,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE Pil OCCUR PREMISES Ea occurrence $100,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY M JERCT 7 LOC PRODUCTS-COMPIOPAGG $2,000,000
<br /> OTHER: Deductible $5,000
<br /> A AUTOMOBILE LIABILITY Y Y 54309639 10/1/2025 10/1/2026 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> X OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> Deductible Comp/Gall $10,000110,000
<br /> C X I UMBRELLALIAB X OCCUR Y Y 03115450-03 10/1/2025 10/112026 EACH OCCURRENCE $12,000,000
<br /> E CXP-059571-03 10/1/2025 10/112026
<br /> EXCESS LIAR CLAIMS-MADE - AGGREGATE $12,000,000
<br /> DED X RETENTION$ $
<br /> A WORKERS COMPENSATION Y 64309538 10/1/2025 10/1/2026 X PERT
<br /> EORH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> STAANYPROPRIETORIPARTNERfEXECUT{VE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICFRIMEMBEREXCWDED7 El NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> D ProfessionaPPollution PCXB-5026074-1025 10/1/2025 10/1/2026 Each Claim $5,000,000
<br /> AgRgregate $5,000,000
<br /> $25,000
<br /> DESCRIPTION OF OPERATIONS f LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Re: Contract:A-2022-065-02-Provide On-Call Demolition Services for the City of Santa Ana. The City of Santa Ana,its officers,officials,employees,and
<br /> volunteers are named as additional insured as respects General and Auto Liability pursuant to written contract,agreement,or memorandum of understanding.
<br /> Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be excess and noncontributory. Waiver of subrogation
<br /> applies to Workers'Compensation. 30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of Premium in accordance with the policy provisions.
<br /> Dlgltally signed
<br /> Tu Tra6hyTuTran
<br /> Nguyen
<br /> Nguyen°zt924 o7oa6 APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION 30 Days
<br /> BYTu Trap ldgugeii a! 2}7 pm;Oct b6 2b25
<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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn: Public Works Agency, CIPIDesign Engineering
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702, M-36
<br /> ©1988-2015 ACORD CORPORATION, All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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