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Digitally,igned by TM Pierson
<br />Tori Pierson Date: 2022.03.0210:SM2
<br />-0srw
<br />FEHR&PE-01 MICHAEI. A
<br />oRo. CERTIFICATE OF LIABILITY INSURANCE
<br />,d►`1112412021
<br />DATE Y
<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 endorsements .
<br />PRODUCER License 9 OE67768
<br />CONTACT Glgl Yuen
<br />IDA Insurance Services
<br />3875 Hopyard Road
<br />Suite 200
<br />PHONE FAX
<br />(A/c, No, Eat): (925) 660-3514 50008 (AIC, Ne):(925) 416-7869
<br />E-MAIL . Gigi.Yuen@ioausa.com
<br />Pleasanton, CA 94588
<br />INSURERS AFFORDING COVERAGE
<br />NAIC 9
<br />INSURER A;RLlInsurance Company
<br />13056
<br />INSURED
<br />INSURER B: Hartford Casualty Insurance Company
<br />29424
<br />INSURER C: LibertySurplus Insurance Corp10725
<br />Fehr& Peers
<br />INSURER D
<br />100 Pringle Avenue, Suite 600
<br />Walnut Creek, CA 94596
<br />INSURER E :
<br />INSURER F :
<br />_
<br />COVERAGES CERTIFICATE NUMBER: REVISION NIIMRFR-
<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 CONTRACTOR 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 />TYPE OF INSURANCE
<br />ADDLJIM
<br />BUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY UPLTR
<br />IDIYYYYI
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE [X] OCCUR
<br />PSB0006683
<br />121612021
<br />12/6/2022
<br />EACH OCCURRENCE
<br />$ 2,000,006
<br />DAMAGETORENTED
<br />PREMISES Ea occurt n
<br />1,000,006
<br />$
<br />MED UP (Any onePerson)
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO LOG
<br />GENERALAGGREGATE
<br />$ 4.000,000
<br />PRODUCTS -COMP/OPAGG
<br />$ 4,000,006
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />1,000,000
<br />$
<br />BODILY INJURY Per eson)
<br />$
<br />ANY AUTO
<br />SSULED
<br />AUTOS ONLY SCHEDULED
<br />PSA0002276
<br />12/612021
<br />12/6/2022
<br />BODILY INJURY Par accident
<br />$
<br />X
<br />PmaeddenI AMAGE
<br />$
<br />AUTOS ONLY X AUrOS ONLY
<br />8
<br />A
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />5,000,000
<br />X
<br />AGGREGATE
<br />5.000.000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />PSE0002889
<br />121612021
<br />12/6/2022
<br />DED RETENTION$
<br />$
<br />B
<br />AND EMPLOYRKERS ERS' IABILITNY YIN
<br />oANV PROPRIETOR/ PARTNER/EXECUTIVE ❑
<br />(Mandatory In NH)EXCLUDED?
<br />If D SCdescribe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />57WEGZJ7989
<br />51112021
<br />5/1/2022
<br />)( PER UTE ERH
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />E.L. DISEABE - EA EMPLOYE
<br />1,000,000
<br />$
<br />E.L. DISEABE- POLICY LIMIT
<br />$ 1,000,000
<br />C
<br />Professional Liab.
<br />AEXNYABEFJ2006
<br />121612021
<br />1216/2022
<br />Per Claim
<br />5,000,000
<br />C
<br />Professional Liab.
<br />AEXNYABEFJ2006
<br />1216/2021
<br />1216/2022
<br />Aggregate
<br />5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Pi 9.1593 Santa Ana On -Call VMT - OC20-0710.00, OC20.0710.01 & OC19-STAN.00
<br />All Operations of the Named Insured, including the aforementioned project, if any.
<br />General Liability: Please see blanket Additional Insured endorsement attached; such coverage is Primary and Non -Contributory, as required per written
<br />contract.
<br />Auto Liability: No company owned vehicles. Please see blanket Additional Insured endorsement, as required per written contract.
<br />GENERAL LIABILITY & AUTO LIABILITY INCLUDE THE FOLLOWING PERSON(S) OR ORGANIZATION(S): The City of Santa Ana, its officers, employees,
<br />agents and representatives, as required per written contract
<br />30-Day Notice of Cancellation is Included per policy provisions.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<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 PROV"""'
<br />Risk MvlrgeeodDM.,
<br />AUTHORIZED REPRESENTATIVE }■}■}■�I'''�9 �-.17EVILIWD&APROIm B, i
<br />`�/�T/"II�J�`.''-e Risk Mana9enmrUmal Ana
<br />ACORD 25 (2016103) ©1988-2015 ACORD C( I/ \
<br />The ACORD name and logo are registered marks of ACORD
<br />
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