Laserfiche WebLink
Docusign Envelope ID: 8FD963A5-AOBA-4092-9D63-D9OC2626FD18 <br />HUNTCON-11 <br />ADAVIS2 <br />,acofro„ CERTIFICATE OF LIABILITY INSURANCE <br />�--- '' <br />DATE(MM/DD/YYYY) <br />4/2/2025 <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 # 0757776 <br />HUB International Insurance Services Inc. <br />9855 Scranton Road <br />Suite 100 <br />CONTACT Alisha Davis <br />NAME: <br />PHONE ) FAX No):(951) 231-2572 <br />(A/C, No, Ext): (877 825-2681 <br />E-MAIL alisha.davis@hubinternational.com <br />San Diego, CA 92121 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Westchester Surplus Lines Insurance Co. <br />10172 <br />INSURED <br />INSURER B:ACE Property & Casualty Insurance Company <br />20699 <br />Hunter Consulting, Inc. <br />DBA HCI Environmental & Engineering Services, Inc. <br />INSURER C: Praetorian Insurance Company <br />37257 <br />PO Box 2745 <br />INSURER D : <br />INSURER E: <br />Corona, CA 92878 <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 001 <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 />$ 1,000,000 <br />CLAIMS -MADE X OCCUR <br />X <br />X <br />G47375320 003 <br />1113012024 <br />1113012025 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />300 000 <br />$ <br />MED EXP (Any oneperson) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />X POLICY JJECT LOC <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />1,000,000 <br />$ <br />X <br />BODILY INJURY Perperson) <br />$ <br />ANY AUTO <br />X <br />H08883397 003 <br />1113012024 <br />1113012025 <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 />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 4,000,000 <br />X <br />AGGREGATE <br />$ 4,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />G47375332 003 <br />1113012024 <br />1113012025 <br />DED RETENTION $ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />N /A <br />X <br />202001426 <br />1113012024 <br />1113012025 <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 />G47375320 003 <br />1113012024 <br />1113012025 <br />Claims Made/Each Occ <br />1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Revised 4/2/2025 This certificate rescinds and supersedes any and all prior certificates issued on behalf of the Named Insured. <br />City of Santa Ana, It's Officers, Employees, Agents, Volunteers and Representatives are Additional Insureds with regards to the General Liability policy when <br />required by a written contract, per the attached endorsement forms CG2010 04/13 and CG2037 04/13. Primary & Non -Contributory wording applies with <br />regards to the General Liability policy when required by a written contract, per the attached endorsement form ENV3252 12/18. Waiver of Subrogation applies <br />with regards to the General Liability policy when required by a written contract, per the attached endorsement form ENV3143 03/05. Waiver of Subrogation <br />applies with regards to the Auto Liability policy when required by a written contract, per the attached endorsement form DA13115A 06/14. Waiver of <br />Subrogation applies with regards to the Workers Compensation policy when required by a written contract, per the attached endorsement form 10217 04/18. <br />.. ......... ........ ........ 1 <br />AFFKUVCU <br />By Tu 7ran Nguyen at 5.49 ain, Afar 03, 202 <br />City of Santa Ana Digitally signed <br />20 Civic Center Plaza Tu Tran by Tu Tr <br />Santa Ana, CA 92701 Ng,y n <br />Nguyen 084948 -07003 <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 />/ , .1........... <br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />