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CALIFORPRO KELVINM
<br /> '4 CERTIFICATE OF LIABILITY INSURANCE D 511YYY)
<br /> 5l1912022026
<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 License#0252636 CONTACT George Duran
<br /> NAMDuran Risk&Insurance Services PHONE FAX
<br /> 3257 E.Guasti Ave,Suite 100 (AtC,No,Ext):(949)933-2845 _(AX.No)-
<br /> Ontario,CA 91761 E-MAIL ADDRESS:g g
<br /> eor a drisinc.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC# _
<br /> INSURER A:Endurance American Specialty Insurance Company I41718
<br /> INSURED INSURER B:MS Transverse Specialty Insurance Company_ _ 41807
<br /> California Professional Engineering Inc. INSURER C:RSUI Indemnity Company_, 22314
<br /> 19062 San,lose Avenue INSURER D:ACE American Insurance Company 22667
<br /> La Puente,CA 91748 INSURER E:Admiral Insurance Company 24856 _
<br /> INSURER 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 /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAPD CLAIMS.
<br /> INSR ADDTYPE OF INSURANCE INSD SUBRWVI) POLICY NUMBER POLICY EFF ! POLICY EXPLTR LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY MM/QDiYYYYi1 EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR ?GL30005056100 4121202a 412/2027 -PREMDAMAISES 100,000
<br /> _�. X X PREMISES Ea oceurrenee $
<br /> MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'LAGGREGA_TE LIMdT APPLIES PER: I GENERALAGGREGATE $ 2,000,000
<br /> X POLICY� PRO LOG 2,000,000
<br /> JECT PRODUCTS-COMPlOP AGG
<br /> OTHER $
<br /> COMBINED SINGLE LIMIT
<br /> B AUTOMOBILE LIABILITY Ea aceidentl $ 1,000,000
<br /> X ANY AUTO X X TSRSCA000027800 5/19/2025 6/19/2026 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED I
<br /> AUTOS ONLY I AUTOS I BODILY INJURY Per accident $
<br /> HIRED I
<br /> NON-OWNED PROPERTY DAMAGE
<br /> -- AUTOS ONLY AUTOS ONLY fPer accidentp $
<br /> C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> X EXCESS LIAB CLAIMS
<br /> -MADE X NHA606723 511912025 6/19/2026 AGGREGATE _ $ 5,006,000
<br /> DED I RETENTION$ $
<br /> D WORKERS COMPENSATION PER I I OTH-
<br /> AND EMPLOYERS'LIABILITY YIN X STATUTEER
<br /> ANY PROPRIETORJPARTNER]tXECUT1,000,000
<br /> IVE912981 5/1912026 5/1912027 EL EACH ACCIDENT $ _
<br /> OFFICERIMEMBER EXCLUDED? NIA'
<br /> {Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000
<br /> If yes describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> E Excess-5M xs 5M i ,UX00000001903 5119/2025 6119/2026 Aggregate 5,000,000
<br /> E Excess-5M xs 5M W00000001903 51191202-1 6/19/2026 Each Occurrence 5,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more spp�ace is required
<br /> NO.:21.095 ON-CALL CONSTRUCTION SERVICES FOR TRAFFIC SIGNALS,STREET LIGHTS AND CONCRETE WHEELCHAIR RAMPS
<br /> The City,its officers,officials,employees,and volunteers are to be covered as additional insureds respect to General Liability per forms CG20101219&
<br /> CG20371219 and Auto Liability per form CA20481013.This insurance is primary and non-contributory with respect to General Liability per form CG20010413.
<br /> *At least thirty(30)days notice of cancellation.Ten(10)days notice for non-payment of premium.
<br /> APPROVED _
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 7:24,am,Jun 03,2026
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Clerk of the City Council THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana
<br /> 20 Civic Center Plaza(M-30)
<br /> P.O.Box 1988 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana,CA 92702-1988
<br /> ACORD 25(2016103) O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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