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<br /> A`ORE CERTIFICATE OF LIABILITY INSURANCE DATE(M4/2024
<br /> 06/14/2024
<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 CONTACT WTW Certificate Center
<br /> NAME:
<br /> Willis Towers Watson Midwest, Inc. PHONE 1-877-945-7378 FAX 1-888-467-2378
<br /> c/o 26 Century Blvd (A/C.No.Ext). (A/C,No): -
<br /> E-MAIL
<br /> P.O. Box 305191 iV)DRE§s: ce ificates@wtwco.co
<br /> -
<br /> Nashville, TN 37230519 USA • D�1'1'lc�l�iJl i a�� S F GG OVERAGE NAIC#
<br /> INSIIRERA: Lib ty Mu 1 Fire Insurance Company 23035
<br /> INSURED tur fJ'�� O(i su ru/F [lcm) an 24074
<br /> HDR Engineering, Inc. Y R/ \ 1d ,eVeSSAV0n y
<br /> 1917 South 67th Street SURERC: :Y 42409
<br /> Omaha, NE 68106 Date! 2024.06.20
<br /> I UR Rr
<br /> COVERAGES IC E 3 4U — ISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE' LIF,ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, -EP".i OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE neSURANCE 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 EFF POLICY EXP
<br /> LTR INSOJyVn POLICY NUMBER (MMIDDIYYYY) (MM/DD/YYYYL LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE X OCCUR PRTORENTED
<br /> PREEMIMI ESES(Ea occurrence) $ 1,000,000
<br /> A X Contractual Liability MED EXP(Any one person) $ 10,000
<br /> Y Y TB2-641-444950-034 06/01/2024 06/01/2025 2,000,000
<br /> PERSONAL&ADV INJURY $
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY X PRO X LOC 4,000,000
<br /> JECT PRODUCTS-COMP/OP AGG $
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT
<br /> (Ea accident) $ 2,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED Y Y AS2-641-444950-044 06/01/2024 06/01/2025 BODILY INJURY Per accident $
<br /> AUTOS ONLY AUTOS ( )
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY (Per accident) $
<br /> $
<br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> B -
<br /> X EXCESSLIAB CLAIMS-MADE Y Y EUO(25)57919363 06/01/2024 06/01/2025 AGGREGATE $ 5,000,000
<br /> DED X RETENTION$0 $
<br /> WORKERS COMPENSATION Xv PER OTH
<br /> STATUTE
<br /> ER
<br /> AND EMPLOYERS'LIABILITY
<br /> YIN
<br /> C ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBEREXCLUDED? No N/A Y WA7-640-444950-014 06/01/2024 06/01/2025
<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 S
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> Certificate Holder is named as Additional Insured on General Liability, Automobile Liability and Umbrella/Excess
<br /> Liability on a Primary, Non-contributory basis where required by written contract. Waiver of Subrogation applies on
<br /> General Liability, Automobile Liability, Umbrella/Excess Liability and Workers Compensation where required by written
<br /> contract and as permitted by law. Umbrella/Excess policy is follow form over General Liability, Auto Liability and
<br /> Employers Liability.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF- NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PRC\ if
<br /> City of Santa Ana Risk Managenen#Division
<br /> Attn: CIP Contracts AUTHORIZED REPRESENTATIVE Ni(1 °� RE1EWED&APPROVED BY: w
<br /> 20 Civic Center Plaza 1,D
<br /> / ./
<br /> Santa Ana,, CA 92702 (f fir' Risk ManagementSpecialist t
<br /> ©1988-2016 ACORD/
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> SR ID: 26021153 BATCH: 3503386
<br />
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