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Client#: 2039770 HARRIASS5
<br /> DATE(MM/DD/YYYY)
<br /> ACORD.,,, CERTIFICATE OF LIABILITY INSURANCE 1 8/01/2025
<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 any rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Lindsay Murphey
<br /> USI Insurance Services, LLC PHONE FAX
<br /> Lic#OG11911 M No,Ext: (A/c,No):- A
<br /> ADDRESS: lindsay.murphey@usi.com
<br /> 10940 White Rock Rd 2nd FI
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Rancho Cordova, CA 95670
<br /> INSURER A:Continental Insurance Company 35289
<br /> INSURED INSURER B:American Casualty Company of Reading PA 20427
<br /> Harris&Associates, Inc. INSURER C:Allied World Surplus Lines Insurance Co 24319
<br /> 1401 Willow Pass Rd Ste 500
<br /> INSURER D:
<br /> Concord, CA 94520-7964
<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 CONTRACTOR 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 /> ADDLSUBR
<br /> LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> (MM/DD/YYYY) (MM/DD/YYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY X X 7092556540 08/01/2025 08/01/2026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE L*OCCUR PREMISES(ERENTED
<br /> nte) $1,000,000
<br /> X Ded: 0 MED EXP(Any one person) $15,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> PRO-
<br /> POLICY X JECTPRO- X LOC PRODUCTS-COMP/OPAGG $4,000,000
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY X X BUA7092547367 08/01/2025 08/01/202 EOaacc S
<br /> cioenINGLELIMIT $1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY X AUTOS ONLY Per accident $
<br /> A UMBRELLA LIAB X OCCUR 7092552522 8/01/2025 08/01/2026 EACH OCCURRENCE $10000000
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $1 O 000 000
<br /> DED I X I RETENTION$10000 $
<br /> B WORKERS COMPENSATION X 7092555985 08/01/2025 08/01/202 X IPER
<br /> STATUTE EORH
<br /> AND EMPLOYERS'LIABILITY
<br /> Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE 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
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> C Prof/Poll Liab. X 03147924 8/01/2025 08/01/2026 $5,000,000 Each Claim
<br /> Claims-Made $10,000,000 Aggregate
<br /> Ded: $500,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: On-call Engineering Plan Check Services.The City of Santa Ana, its City Council, its officers,
<br /> officials,employees,and volunteers are listed as additional insureds on the General Liability and Auto
<br /> Tu Tran uallysigne by
<br /> T T
<br /> Liability policies,on a primary and non-contributory basis,when required by written contract, per uran Nguye
<br /> attached.Waiver of Subrogation applies to General Liability,Auto Liability,Workers Compensation,and Date:2025.09. 5
<br /> Professional Liability policies,when required by written contract, per attached. Excess Follows form.30 Nguyen 12:11:59.07'0
<br /> Days notice of cancellation applies, per attached. APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> By Tu Tran Nguyen at 12:10 pm,Sep 05, 2025
<br /> 2029 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 1240002000
<br /> ( ) THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza (M-30),
<br /> P.O. Box 1988 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana, CA 92702
<br /> © 8-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br /> #S50344432/M50329231 TABZP
<br />
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