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,tc RHO CERTIFICATE OF
<br />LIABILITY INSURANCE
<br />DATE
<br />09/0(4/19YYY)
<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,
<br />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 endorsements .
<br />PRODUCER
<br />CONTACTkathy
<br />PRIMEINSURANCE SERVICES, INC.
<br />9891 IRVINE CENTER DRIVE #160
<br />IRVINE, CA 92618-4319
<br />OD48024
<br />PHONE (g49) 450-2300 FA/C Nol(949) 450-2311
<br />E-MRIL a y pr�.mepa icy.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC>Y
<br />IISIJIFIA SENTINEL INSURANCE COMPANY
<br />11000
<br />INSURED ENGINEERING SOLUTIONS SERVICES
<br />INSURER e: KINSALE INSURANCE CO.
<br />38920
<br />23232 PERALTA DR., SUITE 112
<br />LAGUNA HILLS, CA 92653
<br />INSU,E,C HARTFORD ACCIDENT & INDEMNITY
<br />22357
<br />INSURER D: HISCOX INSURANCE COMPANY, INC
<br />10200
<br />INS1IRERF UNITED FINANCIAL CAS CO.
<br />(949) 637-1405
<br />INSURER P
<br />( 949) 637-1405
<br />C'OVFRAC,FS r.FRTIFIr'ATF NUMRFR 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 />LTR
<br />TYPE OF INSURANCE
<br />n
<br />POLICY
<br />C F
<br />P DD Y
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE —1 OCCUR
<br />F
<br />I c r c
<br />s 2,000,000
<br />MED EXP(Anyone person)
<br />$ 10 000
<br />A
<br />X
<br />1� ''T a
<br />729MXT9447
<br />08/19/2019
<br />8/19/2020
<br />PERSONAL BADV INJURY
<br />s 2,000,000
<br />A'OTHER
<br />L AGGREGATE LIMIT APPLIES PER:
<br />POI,ICY PRO LOC
<br />JECT$
<br />GENERAL AGGREGATE
<br />S 4,000,000
<br />PRODUCTS-COMP/OPAGG
<br />$ 4 000 000
<br />AUTOMOBILE LIABILITY
<br />CCYM9TNLD SINGLE LIMIT
<br />$ 2,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />E
<br />R OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED NON -OWNED
<br />X AUTOS ONLY AUTOS ONLY
<br />X
<br />01083720-0
<br />9/03/2019
<br />9/03/2020
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />$
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />g
<br />X
<br />AGGREGATE
<br />$ r ,
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />X
<br />0100061807-2
<br />8/29/2019
<br />/29/2020
<br />RETENTION
<br />s
<br />C.
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? Y
<br />(Mandatory In NH)
<br />N/A
<br />72WECGG6484
<br />8/20/2019
<br />/20/2020
<br />a' PERT F OR -
<br />EL EACH ACCIDENT
<br />$ 1,000,000
<br />EL DISEASE- EA EMPLOYEE
<br />$ 110001000
<br />A -POLICY IT
<br />DISEASE
<br />1 000 OOQ
<br />Ifyes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />A
<br />BUSINESS PERSONAL PROPERTY
<br />B/19/2020
<br />B. P. p
<br />$13, 100
<br />D
<br />PROFESSIONAL LIABILITY
<br />I72SBAIT9447
<br />MPL2343339.19
<br />18/19/2019
<br />8/29/2019
<br />8/29/202o
<br />p,LIABILITY
<br />$3M/$3M
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule,may be attachedif more space is required)
<br />City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds
<br />with respect to General and auto Liability per attached Endorsements as required by written
<br />contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to Worker's
<br />Compensation. 30 day notice of C ���[��Iice for non-payment of premium in
<br />accordance with the policy provia�Rl MANAGEMENT DIVISION
<br />Y
<br />('FRTIFii'AT' I-nl r)FR I __--k4XP 19 Aftc-Fi I ATiom
<br />Additional Insured:
<br />City of Santa Ana
<br />Risk Management Divisio,,AM�,T"M.
<br />�N Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />�tATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />CORDANCEWITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana, CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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