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Client#: 25181 DII slgnM by Tod Pletwn PSOMAS Tod Pierson-0r00. =.aa300I ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMmDNYY'O 3/28/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Greyling Ins. Brokerage/EPIC 3780 Mansell Road, Suite 370 Alpharetta, GA 30022 CONTACT Sabrina Wynn PHONE 470.785.2254 FAX AIC No Ez[: A/C, No: EMAIL Winn brna.re Iln ADDRESS: SaY @9 Y g•com INSURERS) AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins. Co. 19445 INSURED Psomas INSURER B: Everest National Ins Co 10120 555 S. Flower Street INSURER C: Suite 4300 INSURER D: Los Angeles, CA 90071 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 22-23 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSRL BR MD POLICY NUMBER MMIODY� MWODYYYP LIMITS A X COMMERCIAL GENERAL UABILITY CLAIMS -MADE 4 OCCUR GL5268212 4/01/2022 04/01/2022 EACH OCCURRENCE $1,000000 PREMISES Ea RENTED $SO— D OOO GEN'L MED EXP (Any one person) $25 OOO PERSONAL S ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: PRO - POLICY[ X JECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OPAGG $2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY X NON -OWNED AUTOS ONLY CA4489706 D410112022 04/01/202 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accitlent ) $ PROPERTY DAMAGE (Peroccident) $ B X uMBRELLALIAe EXCESS I X OCCUR CLAIMS -MADE XC80000043221 4/0112022 04/01/202 EACH OCCURRENCE $1 000000 AGGREGATE $1 000 000 DED X RETENTION$10000 g A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC015893764(AOS) WC015893765(CA) 04/01/2022 04/01/2022 04/01/2023 04/01/2023 X PER oTH- E.L. EACH ACCIDENT $1,000000 E.L. DISEASE - EA EMPLOYEE $1 00O 000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be allached if more space is required) Psomas Project #2SAN051300; ON -CALL ENGINEERING SERVICES FOR WATER RESOURCES DIVISION. CITY OF SANTA ANA, its officers, employees, agents, volunteers and representatives is named as Additional Insureds with respects to General & Automobile Liability where required by written contract. The above referenced (See Attached Descriptions) City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVERdli$Iar�gakrd U.is..n. r I�i4m�6APPROJQ9- �jp. � %u Preztdn RaklNruuermrz aA,al a,n. ACORD 25 (2016/03) 1 of 2 #S3192709/M3167478 © 1988-2015 ACORD C LoO The ACORD name and logo are registered marks of ACORD SWY01