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Dig itaI Iysigned by Francine R.
<br />Francine R. Villareal Villareal
<br />Date: 2021.07.07 14.41.39-07'00'
<br />ENVIPLA-02 SUMMANR
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />FMATE (MM/DD1YYYY)
<br />6/30/2021
<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 # OE67768
<br />CONTACT Rita Summan
<br />NAME:
<br />PHONE FAX
<br />(A/C, No, Ext): (925) 416-7862 (A/C, No):
<br />IOA Insurance Services
<br />3875 Hoppyard Road
<br />Suite 200
<br />a D"DRIESS: Rita.Summan@ioausa.com
<br />Pleasanton, CA 94588
<br />INSURER S AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Continental Casualty Company
<br />20443
<br />INSURED
<br />INSURERB: Hartford Casualty Insurance Company
<br />29424
<br />Environment Planning Development Solutions Inc dba EPD
<br />Solutions Inc
<br />INSURER C :
<br />2 Park Plaza, Suite 1120
<br />INSURER D :
<br />INSURER E :
<br />Irvine, CA 92614
<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 PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE DWI X OCCUR
<br />X
<br />X
<br />B6025654530
<br />6/23/2021
<br />6/23/2022
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />1,000,000
<br />$
<br />VIED EXP (Any oneperson)
<br />$ 10,000
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY X JECT El LOC
<br />PRODUCTS - COMP/OPAGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />CMBINED SINGLE LIMIT
<br />EaOaccident
<br />1,000,000
<br />$
<br />BODILY INJURY Perperson)
<br />$
<br />ANY AUTO
<br />X
<br />X
<br />B6025654530
<br />6/23/2021
<br />6/23/2022
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accident
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />A
<br />X
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 4,000,000
<br />EXCESS LAB
<br />X
<br />CLAIMS -MADE
<br />X
<br />X
<br />B 6025663132
<br />6/23/2021
<br />6/23/2022
<br />AGGREGATE
<br />$ 4,000,000
<br />DED X RETENTION $ 10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N/A
<br />X
<br />57 WEG AC20BW
<br />9/30/2020
<br />9/30/2021
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />A
<br />Professional Liab.
<br />X
<br />EEH591923312
<br />9/30/2020
<br />9/30/2021
<br />Per Claim
<br />2,000,000
<br />A
<br />Professional Liab.
<br />X
<br />EEH591923312
<br />9/30/2020
<br />9/30/2021
<br />Aggregate
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana is included as additional insured on Commercial General Liability and Hired and Non -Owned Auto Liability, as required by written contract.
<br />Waiver of Subrogation and Primary and Non -Contributory Provision included on Commercial General Liability Policy, as required by written contract. Waiver
<br />of Subrogation Provision included on Workers Compensation policy, as required by written contract..Commercial Excess Liability policy follows form with the
<br />Commercial General Liability, Hired and Non -Owned Auto Liability and Employers Liability Policies. and Employers Liability Policies. Should any of the above
<br />described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. Professional Liability is a
<br />claims made policy and includes Waiver of Subrogation Provision as required by written contract.
<br />30-Day Notice of Cancellation is included per policy provisions.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF,
<br />NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Santa Ana
<br />AUTHORIZED REPRESENTATIVE
<br />Risk Management Divison
<br />20 Civic Center Plaza, 4th Floor
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<br />RiskManagmentDivisian
<br />REVIEWED & APPROVED BY.-
<br />Santa Ana CA 92701
<br />ACORD 25 (2016/03)
<br />© 1988-2015 ACORD CII
<br />The ACORD name and logo are registered marks of ACORD
<br />Risk Management Analyst
<br />
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