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DATE(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE 8/14/2024
<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
<br /> NAME: Danl Schulze
<br /> AssuredPartners Design Professionals Insurance Services, LLC PHONE FAX
<br /> 3697 Mt. Diablo Blvd Suite 230 A/C No EXt: 714-202-0390 A/c,No):
<br /> Lafayette CA 94549 ADDRESS: CertsDesignPro@AssuredPartners.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:6003745 INSURERA:Aspen Specialty Insurance Company 10717
<br /> INSURED PROAENG-01 INSURER B: Citizens Insurance Company of America 31534
<br /> Proactive Engineering Consultants
<br /> 200 S. Main Street, Suite 300 INSURERC:Allmerica Financial Benefit Insurance Company 41840
<br /> Corona CA 92882 INSURERD: Hartford Casualty Insurance Company 29424
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1132971798 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> B X COMMERCIAL GENERAL LIABILITY Y Y OBFJ100553 8/7/2024 8/7/2025 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea or
<br /> $1,000,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> PRO-
<br /> POLICY� ECT1:1 LOC PRODUCTS-COMP/OPAGG $4,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY Y Y AWFJ100189 8/7/2024 8/7/2025 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> B X UMBRELLALIAB X OCCUR Y Y OBFJ100553 8/7/2024 8/7/2025 EACH OCCURRENCE $5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED X RETENTION$n $
<br /> D WORKERS COMPENSATION Y 57WEGBH5UCM 8/7/2024 8/7/2025 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> ❑
<br /> OFFICER/MEMBER EXCLUDED? NIA
<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 Professional Liability AAAE300254-04 8/7/2024 8/7/2025 Per Claim $2,000,000
<br /> Aggregate Limit $2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The Umbrella Policy is follow form to its underlying Policies:General Liability/Auto Liability/Employers Liability.
<br /> Re:All Operations of the Named Insured.
<br /> The City of Santa Ana, its officers,officials,employees and volunteers are named as an additional insured as respects general liability as required per written
<br /> contract. General Liability is Primary/Non-Contributory per policy form wording.
<br /> APPROVED
<br /> By Cynthia Mora at 11:34 am, Dec 05, 2024
<br /> CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702
<br /> @ 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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