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<br />A� or CERTIFICATE OF LIABILITY INSUF/4� i e si
<br />r413�/' """
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPO HE CEF rIF
<br />[OLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER TFk COVERAGE AFFC •')EiP BY THE OLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE N N JS 'IMGBN�UDRIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have DI L U J pro v -
<br />.be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an indorse2,61 1 _# on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). LlJ
<br />Y
<br />.�1
<br />PRODUCER
<br />Arthur J. Gallagher Risk Management Services, Inc.
<br />300 S. Riverside Plaza, Suite 1500
<br />Chicago IL 60606
<br />CONTACT
<br />NAME: Amber ChaVln
<br />_
<br />205
<br />PHONE . 312.80IL A
<br />3.E
<br />FAX No:
<br />-
<br />nooaess: amber chavin a' r Jim --07'00
<br />1
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />INSURERA: Starr Surplus Lines Insurance Company
<br />13604
<br />INSURED ALLENVI41
<br />All Environmental, Inc.
<br />INSURER B: Starr Indemnity & Liability Company
<br />38318
<br />2500 Camino Diablo
<br />INSURER C:
<br />INSURER 0:
<br />Walnut Creek, CA 94597-3998
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 1372664205 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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />J=
<br />wyn
<br />POLICYNUMBER
<br />POLICY EFF
<br />fMMMD1YYYY1
<br />POLICY EXP
<br />IMMADDVVYYVILIMITS
<br />A
<br />X
<br />COMMERCIALGENERALDABILRY
<br />CLAIMS -MADE FRI OCCUR
<br />Y
<br />Y
<br />10DO065986211
<br />9/14/2021
<br />9/14/2022
<br />EACH OCCURRENCE
<br />$2,000,000
<br />PREMISES Ea occurrence
<br />$300.000
<br />X
<br />MED EXP (Any one person)
<br />$ 25,000
<br />Contractors Pall
<br />$2M/$4M Limits
<br />PERSONAL&ADV INJURY
<br />$1.000,000
<br />X
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$4,000,000
<br />POLICY JCTELOC
<br />PRODUCTS-COMP/OP AGO
<br />$4,000,000
<br />1 GL Dec: $5.000
<br />$
<br />OTHER: CPL Ded: $50.000
<br />1
<br />1
<br />R
<br />AUTOMOBILE LIABILITY
<br />1000638062211
<br />9/14/2021
<br />9/14/2022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY(Par accident )
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />aW GE
<br />Pertlentent)
<br />(Param
<br />$
<br />$
<br />Camp: $2,000 Cg11:$2,000
<br />A
<br />UMBRELLA LIAB
<br />X OCCUR
<br />1000336767211
<br />9/14/2021
<br />9/14/2022
<br />EACH OCCURRENCE
<br />$5,000,000
<br />X
<br />AGGREGATE
<br />$5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEO RETENTIONS
<br />$
<br />B
<br />WORRERSCCMPENSATWO
<br />AND EMPLOYERS'LIABILITY YIN
<br />100 0003855
<br />9/14/2021
<br />9/14/2022
<br />X I STATUTE ERH
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />ANYPROPRIETOWPARTNEWEXECUTIVE ❑
<br />OFFICERIMEMBEREXCLUDED9
<br />NIA
<br />E.L. DISEASE -EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS cal.
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000.000
<br />A
<br />Professional Liability
<br />Claims Made
<br />PL Dec: $10,00D
<br />1000065986211
<br />9/14/2021
<br />9/14/2022
<br />Each Claim
<br />Aggregate
<br />$2,000,000
<br />$4,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule maybe attached if more space is required)
<br />City of Santa Ana and City of Santa Ana Public Works Agency is included as Additional Insured, per written contract or agreement, with regards to General
<br />Liability per form number CG 20 10 04 13, subject to policy terms, conditions and exclusions. The insurance provided in the General Liability policy is primary
<br />and any other insurance shall be excess only and not contributing, per form number SL 023 (6/11) (General Liability) A Waiver of Subrogation in favor of the
<br />Additional Insureds applies, per written contract or agreement, with respect to General Liability per form number SL 023 (06/11). A 30 Day Notice of
<br />Cancellation applies in favor of the Certificate Holder as required by written contract.
<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 and City of Santa Ana Public Works ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Agency
<br />20 Civic Center Plaza M-83 AUTHO IZED REPRESENTATIVE
<br />Santa Ana CA 92701
<br />RWtMnsgaNmtDmiton
<br />REwEwED & APPRO act Sr
<br />©1988-2015 ACORD u` -'a AFry:. Acwgfo
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management specikist
<br />
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