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AIR[]® CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDIYYYYI <br /> 11/4/2024 <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 CO�NTEACT Dolores Muir <br /> Andreini&Company PHONE <br /> 220 West 20th Avenue N Ex II,650-573-1111 A/c No:650-378-4361 <br /> San Mateo CA 94403 E-MAIL <br /> ADDRESS: dmuir andreini.com <br /> INSURER(S AFFORDING COVERAGE NAIC# <br /> INSURER A: Scottsdale Insurance Company 41297 <br /> INSURED MMCIN-1 Mehlta Mechanical Company, Inc. INSURER B:West American Insurance Co. 44393 <br /> INSURER Tokio Marine Specialty Ins Co Dba: MMC, Inc. 23850 <br /> 5901 Fresca Drive INSURER D: <br /> La Palma CA 90623 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1775040751 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 ADDL SUER <br /> LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP <br /> INSDWVDMMIDDIYYYY MM1DDlYYYY LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY Y Y BCS2002025 1111/2024 11/112025 EACH OCCURRFNCE $1,000,000 <br /> CLAIMS-MADE OCCUR DAMAGETo TFD <br /> PREMISES(Ea olccur ence $100.000 <br /> X $5,000 Ded MED EXP(Ary one person) $Excluded <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 <br /> POLICY PRO- LOC PRODUCTS-COMP/OP AGG $2,000,000 <br /> OTHER: <br /> B AUTOMOBILE LIABILITY Y Y BAWS9017366 11/112024 11/112025 COMBINED SINGLE-LIMIT $1,000,000 <br /> Ea accident <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED UTO AUTOSNON-OWNED <br /> Y PROPERTYDAMAGE <br /> AUTOS ONLY AUTOS ONLY Per accident $ <br /> Deductible $0 <br /> A UMBRELLA LIAB OCCUR XLS2005547 111112024 11/1/2025 EACH OCCURRENCE $5,0flQ600 <br /> X EXCESS LAB CLAIMS-MADE <br /> AGGREGATE $5,000,000 <br /> DED X HETENTIDN$in nnn $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE I I ER <br /> ANYPROPAIETORIPARTNERIEXECUTIVE <br /> OFFICEnIMEMBEREXCLUDED? ❑ NIA E.L.EACH ACCIDENT $ <br /> (Mandatory in NH)It yes,describe under E.L.DISEASE-EA EMPLOYEE $ <br /> TION OF OPERATIONS below F.L DISEASE-POLICY LIMIT $ <br /> 71t�� <br /> ss Liab excessOf PUB887405001 11/112024 11/1/2025 1,000,000 Excess Liab <br /> ss Liability <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Re: RFP 22-147A New Prefabricated Restroom Installation at(4)City Parks <br /> The City of Santa Ana, its officers,officials,employees,and volunteers are included as additional insureds for General Liability per attached forms CG 20 10 <br /> 12-19&CG 20 37 12-19. Waiver of subrogation applies per form CG 24 04 12-19.Such insurance is primary&non-contributory per form CG20010413. 30 <br /> day notice of cancellation applies per form UTS-410g 02-11. <br /> The City of Santa Ana, its officers,officials,employees,and volunteers are included as additional insureds for Auto Liability per attached farm CA 20 48 02 99, <br /> Waiver of subrogation applies per form AC85430618.Such insurance is primary&non-contributory per form AC85430821. 30 day notice of cancellation applies <br /> per form CA 88 63 09 12. <br /> Umbrella Liability follows form. These attached endorsements are part of the above listed policies. APPROVED <br /> CERTIFICATE HOLDER CANCELLATION By Cynthia Mora at 11.12am.Jan 06,2025 <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 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Risk Management Division <br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92702 <br /> O 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />