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ALc ® DATE (MM/DDNYYY)
<br />v CERTIFICATE OF LIABILITY INSURANCE 02/23/23/20242024
<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 grid ette Piazza
<br />McGriff Insurance Services, LLC NAME: 9
<br />2000 International Park DAnqie
<br />c E' •1 00 4 211 • aC, No
<br />Suite 600 M r t m
<br />Birmingham, AL 35243
<br />INSURERS) AFFORDING COVERAGE NAIC #
<br />I A: v e as t y 25674
<br />INSURED INSUPWR B :I he I rav n emnl y ompany o America 25666
<br />ARC Document Solutions, Inc.
<br />345 Clinton Street I ERC Atlantic S I ra e y 27154
<br />Costa Mesa, CA 92626 A•
<br />40l
<br />I S •
<br />INSURER E :
<br />COVERAGES
<br />CERTIFICATE NLiV!1317 �
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE '_IST_D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TEIL.; 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/YYY
<br />LIMITS
<br />C
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />711018408-0000
<br />02/26/2024
<br />02/26/2025
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE � OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 15,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />X
<br />X
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY X PRO LOC
<br />JECT
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />711018408-0000
<br />MA Only Auto: 390001705-0000
<br />02/26/2024
<br />02/26/2025
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />x
<br />HIRED XNON-OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />C
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />711018408-0000
<br />02/26/2024
<br />02/26/2025
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I X I RETENTION $
<br />$
<br />A
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />UB2L7502842351 K (AOS)
<br />UB2L6010822351 R (AZ, FL, GA, MA,
<br />NE, OR, SC, WI)
<br />02/26/2024
<br />02/26/2025
<br />X SPER TATUTE OTH
<br />ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />(Mandatory in NH)
<br />N / A
<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 />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Re: Reprographic Services.
<br />City of Santa Ana, its officers, agents and employees are Additional Insured under General Liability which applies on a primary and non-contributory basis as required by
<br />written contract. In the event of cancellation by the insurance companies, the policies have been endorsed to provide 30 days notice of cancellation (except for non
<br />payment) to the certificate holder as required by written contract. General Liability coverage contains Separation of Insureds as provided by policy wording.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th floor
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCR
<br />THE EXPIRATION DATE THEREO
<br />ACCORDANCE WITH THE POLICY PR(
<br />AUTHORIZED REPRESENTATIVE
<br />Risk ManagmumtDMslcrn
<br />% x REVIEWED & APPROVED BY.
<br />Risk Management Specialist
<br />Page 1 of 19 © 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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