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ACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/4/2024 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 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Di i�ally signed b c Regina Caindoy Arthur J. Gallagher Risk Management Serv,;es L A8t A e E Acevedo i� Acevedo e A o Date:2024.03.06 PHONE- FAX A/C No Ext : 425-586-1034 A/C, No): E-MAIL s regina_caindoy@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: National Union Fire Insurance Company of Pittsburg 19445 -08,00, INSURED Shannon & Wilson, Inc. ATTN: Travis Deane INSURERB: New Hampshire Insurance Company 23841 INSURERC: INSURERD: 100 N. First Street, Suite 200 Burbank CA 91502 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 1736351153 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 CONTRACT OR 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 5180256 3/1/2024 3/1/2025 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO - POLICY � ECT1:1 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y 2961686 3/1/2024 3/1/2025 COMBINED SINGLE LIMIT Ea accident $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N WC012016021P(AOS) WC012016020(CA) 3/1/2024 3/1/2024 3/1/2025 3/1/2025 X PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? FN] N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re Workers' Comp- in Monopolistics, Employers' Liability only City of Santa Ana, its offers, officials, employees and volunteers are included as Additional Insured for General Liability (per CG2010 and CG2037), Auto as respects operations of the Named Insured and where required by written contract. GL, AL Primary and Non -Contributory is included where required by written contract. Waiver of Subrogation is included where required by written to contract. RE: City of Santa Ana On -Call Engineering Services. S&W Job No. 111155. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Attn: Jennifer L. Hall 20 Civic Center Plaza (M-30) PO Box 1988 Santa Ana CA 92702 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC oR.N a RAManagmumtDMslcrn AUTHORIZED REPRESENTATIVE z f °x RENEWED & APPROVED BY: Rem CRU1 " Risk Management Specialist @ 1988-2015 ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE