|
REALEST-56 SPARKER1
<br /> ,dâ–ºcoRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 7/30/2025
<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#6009644 CONTACT Shirley Parker
<br /> NAME:
<br /> Acrisure West Insurance Services,LLC PHONE FAX
<br /> 1950 W Corporate Way (A/C,No,Ext):(951)600-8100 (A/C,No):
<br /> #1 E-MAIL DD SS:ShParker@acrisure.com
<br /> Anaheim,CA 92801-5373
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURERA:James River Insurance Company 12203
<br /> INSURED INSURER B:Carolina Casualty Insurance Company 10510
<br /> Real Estate Consulting&Services,Inc. INSURER C:Capitol Specialty Insurance Corporation 10328
<br /> 216 Avenida Fabricante
<br /> Suite 110 INSURER D:
<br /> San Clemente,CA 92672 INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM/DD/YYYY MM/DD/YYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE Arl
<br /> Aj OCCUR P0000001571 7/31/2025 7/31/2026 DAMAGE TO RENTED 100,000
<br /> X X PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> Ea accident $
<br /> ANY AUTO BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident)
<br /> ccident $
<br /> A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> X EXCESS LIAB CLAIMS-MADE X X P0000001580 7/31/2025 7/31/2026 AGGREGATE $ 2,000,000
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY X STATUTE ER
<br /> BN U W C0164238 12/1/2024 12/1/2025 1,000,000
<br /> ANY PROPRIETOR/ R/EXECUTIVE N/A E.L.EACH ACCIDENT $
<br /> EXCLU
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> C Pollution Liab EV20230202-03 4/10/2025 4/10/2026 General Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> General Liability is Primary and Non-Contributory.Blanket Additional Insured Endorsement attached in regards to General Liability.Blanket Waiver of
<br /> Subrogation attached in regards to General Liability and Workers'Compensation.Excess Policy follows form over the General Liability.
<br /> Endorsements in favor of The City of Santa Ana, its City Council,its officers,officials,employees,agents,and volunteers. Tu Tran uTrallysigne by
<br /> T
<br /> Re:On-Call TRASH,WEEDS,RUBBISH,&SANITATION ABATEMENT,AND BOARD-UP SERVICES uTran Nguyen
<br /> Date:29-07-0. 0
<br /> Nguyen
<br /> 14:30:29 0
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION ByTu Tran Nguyen at 2:29 pm,Jul 30,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attention: Public Works Agency
<br /> CIP/Design Engineering
<br /> 20 Civic Center Plaza, M-36 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana,CA 92702
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|