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JAMIENG-01 TSONY
<br /> ,4coRO CERTIFICATE OF LIABILITY INSURANCE DATE(M
<br /> 4/25/202YYY)
<br /> 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#0757776 CONTACT Gail Schrenk
<br /> NAME:
<br /> HUB International Insurance Services Inc. PHONE 951 779-8763 FAX 951 742-4679
<br /> PO Box 5345 (A/C,No,Ext):( ) (A/C,No):( )
<br /> Riverside,CA 92517 E-MAIL Cal.CPU@Hubinternational.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:The Travelers Indemnity Company of Connecticut 25682
<br /> INSURED INSURER B:Travelers Property Casualty Company of America 25674
<br /> Jamison Engineering Contractors Inc. INSURER C:State Compensation Insurance Fund of California 35076
<br /> 2525 S.Yale St. INSURER D:Continental Casualty Company 20443
<br /> Santa Ana,CA 92704
<br /> 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 FU71 OCCUR DT22COlYO89473TCT25 3/21/2025 3/21/2026 DAMAGETORENTED 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� JECT1:1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> X ANY AUTO X X BAlY090214252SG 3/21/2025 3/21/2026 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> X Comp&Coll X Ded$1000
<br /> B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> EXCESS LIAB CLAIMS-MADE CUPlY090724252S 3/21/2025 3/21/2026 AGGREGATE $ 5,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> C WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> YIN 90374962025 1/1/2025 1/1/2026 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ X E.L.EACH ACCIDENT $
<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 /> D E&O Liab SIR:$5000 C6057126128 3/21/2025 3/21/2026 Ea Incident 8r Agg 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 1D1,Additional Remarks Schedule,may be attached if more space is required)
<br /> Excess Liability Policy follows underlying policies: GL,Auto,WC Only
<br /> Revised 4/25/2025-This certificate rescinds and supersedes any and all prior certificates issued on behalf of the Named Insured.
<br /> RE:On Call Services.
<br /> City of Santa Ana,officers,agents,employees,representatives and volunteers are Additional Insured with regard to the General Liability policy,when
<br /> required
<br /> APPROVED
<br /> CERTIFICATE HOLDER ANCELLATION
<br /> By Tu Tran Nguyen at 3:55 pm,May 01,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana Dlgitallysigned THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Attn: Heidi Chou TU Tran byTuTran ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Nguyen
<br /> 215 S.Center St. N g Uye n Date:2025.05.01
<br /> Santa Ana,CA 92703 15:56:16-07'00' AUTHORIZED REPRESENTATIVE
<br /> a4_
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
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