Agenda Packet_2023-11-21 - Laserfiche WebLink

Home Browse Search

Digitally signed by F..dc e[L Francine R.V1llarea0)A11a 1 bate.202d1maow9e Aebn' ARff CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 10/30/2020 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(les) 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 GMGS Risk Management & Insurance Services 6201 Oak Canyon, Suite 100 Irvine, CA 92618 GUNJ NAME: CT Jennifer Barton PHONE FAx 949-559-3394 aIc No : 949-559-6703 ADDRESS: 'ennlferb m s.com INSURERS AFFORDING COVERAGE NAIC # WWw.gmgs.Com OB84519 INSURER A: Great Divide Insurance Company 25224 INSURED EEC Environmental INSURER B : American Fire and Casualty Company 24066 dba Enviromental Engineering Contracting Inc., INSURERC: INSURERD: One City Boulevard West, Suite 1800 Orange CA 92868 INSURER E: INSURER F L llV l^_ITLi I•lr� I: IIFII:ll1F MIIMMI-K' 902 ogl1 OC\ll01f kl 11111sAMCO. 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, INTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIDDIYYri POLICY EXP MMID YYY1 LIMITS A I/ COMMERCIAL GENERAL LIABILITY CLAIMS•MADE �/ OCCUR GLP2006942-18 10/3112020 10/31/2021 EACHOCCURRENCE $5000000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300 000 MED EXP (Any one person) $ 25 000 PERSONAL & ADV INJJRY $ 5 000 000 GEN'L AGGREGATE LIMITAPPLIES PER: POLICY F�] jCC7 D LOC OTHER: GENERALAGGREGATE $5,000,000 PRODUCTS - COMPIOP AGG $ 5 00O 000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BAA(21)58333458 10131 /2020 10/31/2021 Ea aBIN D SINGLE LIMIT $ 1 QOQ 000 BODILY INJURY (Per person) $ BODILY INJURY (Per ( ) $ PROPERTY DAMAGE Par accident $ $ UMBRELLALIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WCA200881517 5/2412020 5/24/2021 STATUTE OTRH- E.L. EACH ACCIDENT $ 1 QQQ 00O E.L. DISEASE - EA EMPLOYEE $1,iI E.L. DISEASE - POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: Job #W-1424.12T - Every Drop Counts - Santa Ana WDR This certificate may be relied upon only If the certificate addendum referred to herein is attached hereto, VtrcIlCll AI_C "ULULK CANCELLATION Job #W-1424.12T City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th floor Santa Ana CA 92702 ACORD 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Griff OO 1988-2015 ACORD t Council he name and logo are repTereITarks of ACORD /POLL/E!O/WC I JanniEar Barton 110/30/202D 1:d8:06 PM (Pbc) I Page 1 of 11 'Lesko R1akMmUgancntDlvI kn �T%x idEVIEWED & APPROVED Or S. 1, a 2 �1�[ldnat�em�Flt Analyst 58303173 120-21