|
DATE(MMIDD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 1
<br /> 0412912026
<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). '7�
<br /> PRODUCER CONTACT
<br /> AOn Risk services Northeast, Inc. NAME:
<br /> Aon Risk Services Northeast, Inc. 1C No.Ext): 866-283-7122 FAX No 860-363-0105 v
<br /> NY NY Office E-MAIL
<br /> One Liberty Plaza ADDRESS: z
<br /> 165 Broadway, suite 3201
<br /> New York NY 10006 USA INSURER(S)AFFORDING COVERAGE NAIC p
<br /> INSURED INSURERA: Allianz Global Risks US Insurance Co. 35300
<br /> Bureau veritas North America, Inc INSURERS: Hartford Fire Insurance co. 19682
<br /> 16800 Greenspoint Park Drive
<br /> Suite 300S INSURER C:
<br /> Houston TX 77060 USA
<br /> INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 570119690993 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, Limits shown are as requested
<br /> INSR TYPE OF INSURANCE D POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WvD MMIDDIYYYY MMIODIYYW
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y USL 015 EACH OCCURRENCE S2,000,000
<br /> CLAIMS-MADE OCCUR SIR applies per policy terns & conditions DAMAGE TO RENTED S1,000,001)
<br /> PREMISES Ea occurrence
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL£ADV INJURY $2,000,000 m
<br /> GEN'LAGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE 12,000,000 n
<br /> POLICY L PRO-
<br /> POLICY LOC
<br /> JECT PRODUCTS-COMPIOPAGG $2,000,000 rn
<br /> OTHER: SIR $50,000 O
<br /> n
<br /> B AUTOMOBILE LIABILITY Y Y 10 AB, s41202 01/01/2026 01/01/2027 COMBINED SINGLE LIMIT
<br /> ADS Eaaeci I $l,000,000
<br /> AI
<br /> NY AUTO BODILY INJURY(Par person) Z
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) y
<br /> HIRED AUTOS AUTOS
<br /> NON-OWNED PROPERTY DAMAGE
<br /> ONLY AUTOS ONLY Peraccident
<br /> Comprehensive Deduct $1,000
<br /> m
<br /> A X UMBRELLALIAB X OCCUR Y Y USLOO163326 01/01/202601/01/2027 EACH OCCURRENCE $5,000,000 V
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED X RETENTION 5250,000
<br /> B WORKERS COMPENSATION AND Y IOWNS41200 01/01 2026 01101 2027 X I PER STATUTE 0TH_
<br /> EMPLOYERS'LIABILITY ER
<br /> YIN see state Policy Addendum
<br /> OANY FrICE PRIETORI PARTNER lEXECUTIVE E.L.EACHACCI❑ENT $1,.000,ODO
<br /> OrEICERIMEMDER E%CLDOED7 N P A
<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 /> A Architects & Engineers USFOO248026 01/01/2026 01/01/2027 Each Claim $1,000,000
<br /> Professional Claims Made Aggregate $2,000,000
<br /> SIR applies per policy ter s & condi ions SIR $250,O
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS P 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 included as Additional
<br /> Insured in accordance with the policy provisions of the General Liability, Automobile Liability and Umbrella Liability
<br /> polities. General Liability, Automobile Liability and umbrella Liability policies evidenced herein are Primary and
<br /> Non-contributory to other insurance available to an Additional insured, but only in accordance with the policy's provisions. A
<br /> waiver of Subrogation is granted in favor of the City of Santa Ana, its City council, its officers, officials, employees,
<br /> agents and volunteers in accordance with the policy previsions of the General Liability, Automobile Liability, umbrella ^J
<br /> Liability, workers' compensation, Professional Liability policies. should General Liability, Automobile Liability and workers' �#J
<br /> PIN
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THES
<br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br /> POLICY PROVISIONS.
<br /> city of Santa Ana AUTHORIZED REPRESENTATIVE
<br /> Planning and Building Agencyi
<br /> 20 Civic Center Plaza ` l �
<br /> Santa Ana CA 92701 USA c.]��/a/tea
<br /> APPROVED
<br /> By Tu Tran Nguyen at t 1:12 am,May 20,2026 ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016103) a name an ego are registered marks of ACORD
<br />
|