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ARDURRA-01
<br />KSANCHEZ
<br />.4�oRo CERTIFICATE OF LIABILITY INSURANCE
<br />OAT/YYYY)
<br />8/30/2D30I2022
<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 pollcy(ies) must have ADDITIONAL INSURED provisions or be endoysed.
<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
<br />Ames & Gough
<br />8300 Greensboro Drive
<br />Suite 980
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />(ac,Ne,E:t: (703) 827-2277 AIc,No):(703) 827-2279
<br />E-MAIL
<br />ADDRESS: admin@amesgough.com
<br />McLean, VA 22102
<br />INSURERS AFFORDING COVERAGE
<br />NAIC N
<br />INSURER A:Valley Fore Insurance Company A XV
<br />20508
<br />INSURED
<br />INSURER B:National Fire Insurance Company of Hartford A(XV)
<br />20478
<br />INSURER C: Continental Insurance Company A XV
<br />35289
<br />Ardurra Group, Inc.
<br />INSURER D: National Fire & Marine Insurance Company
<br />20079
<br />4921 Memorial Highway, Suite 300
<br />Tampa, FL 33634
<br />INSURER E
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: RFVICIf)N 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 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 />TYPE OF INSURANCE
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY
<br />EXPETR
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ❑X OCCUR
<br />Contractual Liab.
<br />6075640222
<br />1/1/2022
<br />1/112023
<br />EACH OCCURRENCE
<br />11000,000
<br />DAMAGES RENTEDn
<br />EBEMlaFX
<br />$ 1,000,000
<br />MED EXP (Any oneperson)
<br />$ 15,000
<br />PERSONAL&ADV INJURY
<br />t 11000,000
<br />DEVIL
<br />X
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY j �T LOG
<br />GENERALAGGREGATE
<br />$ 2,006,600
<br />PRODUCTS - COMPIOP A(
<br />$ 2,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />CEa aOMBINcciEDdentSINGLE LIMIT
<br />$ 1,000,000
<br />X
<br />BODILY INJURY Per erson
<br />ANY AUTO
<br />6075640236
<br />1/112022
<br />1/1/2023
<br />BODILY INJURY Per accident
<br />$
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />ROPERTV DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY r AUTOS ONLY
<br />$
<br />C
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 15,000,000
<br />AGGREGATE
<br />1 15,000,000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />6075640270
<br />1/1/2022
<br />1/1/2023
<br />DED I X I RETENTION$ 10,000
<br />C
<br />WORKERS COMPENAND EMPLOYERS' A TIOITY Y;N6075640253
<br />ANY PROPRIETORIPARTNERJEXECUTIVE
<br />OFFICEWMEMBER EXCLUDED? L'-r f
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />1/1 /2022
<br />1/1 /2023
<br />X STAT E EORH
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E, L. DISEASE - EA EMPLOYEN
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,006,000
<br />D
<br />Professional Liab.
<br />42-EPP-306878.04
<br />1/1/2022
<br />1/1/2023
<br />Per Claim/Aggregate
<br />10,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required)
<br />RE: On -Call Engineering Services
<br />The City of Santa Ana, Its Officers, Employees, Agents, and Representatives are included as additional insured with respect to General Liability and
<br />Automobile Liability when required by written contract. General Liability is primary and non-contributory over any existing insurance and limited to liability
<br />arising out of the operations of the named insured and when required by written contract. General Liability, Automobile Liability and Workers Compensation
<br />policies Include a waiver of subrogation in favor of the additional Insureds where permissible by state law and when required by written contract. Umbrella
<br />Liability coverage sits excess over General Liability, Automobile Liability and Employers' Liability coverage. 30-day Notice of Cancellation will be issued for
<br />the General Liability, Automobile Liability, Workers Compensation and Professional Liability policies in accordance with policy terms and conditions.
<br />City of Santa Ana
<br />Risk Management Division
<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 />AGORD 25 (20111103) @ 1988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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