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____44N JAMIENG-01 SGONZALEZ
<br /> 144cORO_ [CERTIFICATE OF LIABILITY INSURANCE DATE 1211 812 0 24Y)
<br /> 12/18/2024
<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 License#0757776 CONTACT Gail Schrenk
<br /> NAME:
<br /> HUB International Insurance Services Inc.
<br /> PHONE FAX
<br /> PO Box 5345 (A/C,No,EXt): (951)779-8763 (A/C,No):(951)231-2572
<br /> Riverside,CA 92517 ADDARESS,cal.cpu@hubinternational.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:The Travelers Indemnity Company of America 25666
<br /> INSURED INSURER B:The Travelers Indemnity Company of Connecticut 25682
<br /> Jamison Engineering Contractors Inc. INSURER C:Travelers Property Casualty Company of America 25674
<br /> 2525 S.Yale St. INSURER D:State Compensation Insurance Fund of California 35076
<br /> Santa Ana,CA 92704 INSURER E:Columbia Casualty Company 31127
<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 EXPITIR LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X occuR DT22C01Y089473TCT24 3/21/2024 3121/2025 DRE ES aoccED 300,000
<br /> X X PREMISES Ea occurrence $
<br /> X PD Ded:$2,500 MED EXP(Any oneperson) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY ] PRO
<br /> POLICYLOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER:
<br /> B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> X ANY AUTO X BAlY0902142426G 3/21/2024 3/21/2025 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED LXX
<br /> NON-OWNED PROPERTYDAMAGE
<br /> AUTOS ONLY AUTOS ONLY per.c,dent $
<br /> X Comp&Coll Ded$1,000
<br /> C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> X EXCESS LIAB CLAIMS-MADE CUPlYO907242426 3/21/2024 3/21/2025 AGGREGATE $ 5,000,000
<br /> DED X RETENTION$ 0 $
<br /> PER OTH-
<br /> D WORKERS COMPENSATION X STATUTE ER
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ X 90374962025 1/1/2025 1/1/2026 E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A
<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 /> E E&O Liab SIR:$5,000 C6057126128 3/21/2024 3/21/2025 Ea Incident&Agg 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Excess Liability Policy following underlying policies:GL,Auto,WC Only
<br /> RE:On Call Services.
<br /> City of Santa Ana,officers,agents,employees,representatives and volunteers are Additional Insured with regard to General Liability when required by written
<br /> contract per the attached endorsement forms CGD361 03105 and CG2037 07/04.Primary&Non-Contributory wording applies with regard to General Liability
<br /> when required by written contract per the attached endorsement form CGT100 02/19.Waiver of Subrogation applies to the General Liability policy,when
<br /> required by written contract,per the attached endorsement form CGD316 02/19.Additional Insured with regard to Auto Liability when required by written
<br /> SEE ATTACHED ACORD 101
<br /> CERTIFICATE HOLDER CANCELLA APPROVED
<br /> SHOULD A By Cynthia Mora at 4:55 pm,Jan 13, 2025 D BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92702 AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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