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A III Digitally signed
<br />ACC) b® CERTIFICATE OF LIABICIM496RAN:: �7 Angie Acev d UTE(MMDDIYYYY)
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<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AN /� 1. C HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, E 'ffibAW3;P A,jfFO)Wj THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE'A'dEEN 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
<br />Marsh USA Inc.
<br />CONTACT
<br />NAME:
<br />PHONE FAX No
<br />525 Vine Street, Suite 900
<br />Cincinnati, OH 45202
<br />E-MAIL
<br />ADDRESS'
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A: Continental Casualty Co.
<br />20443
<br />CN103042465—GAWUE-21-22
<br />INSURED Statewide Traffic Safety 8 Signs, Inc.
<br />INSURER B: American Casual!y Company OfReading, Pa
<br />20427
<br />INSURER C : Continental Insurance Co.
<br />35289
<br />dba Statewide Safety Systems
<br />522 Lindon Lane
<br />Nipomo, CA 93444
<br />msuRERD : Trans ortaticn Insurance Co
<br />20494
<br />INsuRERE: Landmark American Insurance Company
<br />33138
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: CLE-006767953-06 REVISION NUMBER: 12
<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
<br />AODLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />IMM/DDMYYJ
<br />POLICY EXP
<br />imavnn
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERALLIABILITY
<br />CLAIMS -MADE FX] OCCUR
<br />X
<br />X
<br />7014845044
<br />0611
<br />06/152022
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Me occurtence
<br />$ 1,oD0,000
<br />MED EXP Anyone person)
<br />$ 10,000
<br />PERSONAL &AGV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY JE�7 LOG
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMP/OP AGG
<br />S 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />X
<br />7014879999
<br />06/28/2021
<br />06/1512022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 2,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY ( ) cci Per adent
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />X
<br />X
<br />GUE6083004523
<br />061
<br />06/152022
<br />EACH OCCURRENCE
<br />$ 6,000,000
<br />AGGREGATE
<br />$ 6,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I I RETENTION$
<br />$
<br />B
<br />D
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANYPROPRIETOWPARTNEWEXECUTIVE YIN
<br />OFFICEWMEMBEREXCWDEDT N
<br />(Mandatory in NH)
<br />NIA
<br />X
<br />7014973185(ADS)
<br />WC 7015437870 (AZ, OR, Wq
<br />WC 7015437867(CA)
<br />07130/2021
<br />07/302021
<br />06/152022
<br />O6/152022
<br />06/152022
<br />X PER OTH-
<br />STATUTE Eft
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,000
<br />D
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS beow l
<br />GAP 7015437884 (Slop -Gap Coverage)
<br />07/3012021
<br />06/1512022
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />E
<br />Professional/Pollution
<br />LHC789690
<br />06/152021
<br />06/150022
<br />Limit
<br />See Attached
<br />Deductible
<br />5,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Re: Professional traffic control services
<br />The City of Santa Ana, Its officers, employees, agents, volunteers and representatives is/are Included as additional insured where required by written contract with respect o general liability and auto liability. This
<br />insurance is primary and non-contributory over all other Insurance where required by written contract. Waiver ofsubrogalon is applicable where required bywrlten contract and subject to policy terms and
<br />conditions. Umbrella is follow form of primary, subject to policy terms, conditions, and exclusions with respect to general liability, auto liability and workers compensation. Umbrella is follow form of pdmary, subject
<br />to policy tens, conditions, and exclusions.
<br />City of Santa Ana
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />KOF
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />wur WekM�sgmlmtDivLv(oD
<br />,y \2 REVIEWED&APPROVEDBY:
<br />Fl+A�e.,
<br />Risk Management Specialist
<br />
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