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__,.....1.14,1 PALP, INC. _ JCHRISTIANSON
<br /> '4CORCP CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD/YYYY)
<br /> `-.------ 5/31/2024 _
<br /> 1 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 su .h endorsement(s).
<br /> eCONT_�C1 II` r s i g n ;d
<br /> PRODUCER NR,M�LJI 6nV\y/
<br /> HUB International Inrtft;1j_llcg
<br /> ' °E oN
<br /> 4695 MacArthur Court arc,No,Ext): (A/C,No):
<br /> Suite#600 )DRESS: ///yyyNewport Beach,CA 92 As 1R v 6�I mAER tee v e d o NAIL#
<br /> INS,3ER A. ITCO Gen I Insurance Corporation 20095
<br /> INSURED INSU •Gr at Ame Al r.. c=,•- pa•, ,• 16691
<br /> Palp,Inc.D:h, xcing m\/ CI
<br /> LI .; INsu ate.
<br /> 2230 Lemo ill n URER D
<br /> Long Bea. , -
<br /> _ INSURt F1 .3 7.31 -8 0-0'
<br /> COVERAGES CERTIFICATE NUMBEF.: 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/DDIYYYYI IMM/DD/YYYYI
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR CLP3744561 6/1/2024 6/1/2025 DAMAGE TO RENTED 300,000
<br /> X X PREMISES(Ea occurrence) $
<br /> MED EXP(Any one person) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY X PRCOT LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: EB AGGREGATE $ 2,000,000
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000 000
<br /> (Ea accident) $
<br /> X ANY AUTO X X CAP3744560 6/1/2024 6/1/2025 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> X AUTOS ONLY X Al EitiCaWONN5 (Per accident)p AMAGE $
<br /> $
<br /> B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
<br /> X EXCESS LIAB CLAIMS-MADE TUE 3414395 04 6/1/2024 6/1/2025 AGGREGATE $ 1,000,000
<br /> DED I RETENTION$ _ $
<br /> A WORKERS COMPENSATION X STATUTE OTH-
<br /> ER
<br /> AND EMPLOYERS'LIABILITY Y/N X WC3744562 6/1/2024 6/1/2025 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> Mandatory in NH)EXCLUDED? N I A 1,000,000
<br /> E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> RE:Excel Job#5979;RFP#23-182;Santa Ana Annual On-Call Contract. glaipwv/auaiwv/wcwv
<br /> City of Santa Ana,it's officers,officials,employees,and volunteers are included as Additional Insureds as respects General Liability and Auto Liability per
<br /> attached endorsements.
<br /> This insurance shall apply as Primary and Non-Contributory per attached endorsement.
<br /> Waiver of Subrogation for General Liability,Auto Liability and Workers'Compensation:See Attached Endorsements.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREO\ f
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PR( Risk MansgententDivision
<br /> 20 Civic Center Plaza(M-30) g,"'-"`_
<br /> P.O.Box 1988 : REVIEWED&APPROVEDBY: •
<br /> Santa Ana,CA 92702-1988 AUTHORIZED REPRESENTATIVE ` � �o' Aa
<br /> O
<br /> �� Risk Management Specialist
<br /> cfd{�6GldL I /
<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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