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Aca CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDIYYYY)
<br /> 12/5r2024
<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
<br /> Burnham WGB Insurance Solutions NAME: Kristen Perez
<br /> CA Insurance License OF69771 PHONE Ex ,714-505-700fl FAX
<br /> 1 714-573-1770
<br /> 15901 Red Hill Avenue E-MAIL
<br /> ADDREss: kristen. erez w bib.com
<br /> Tustin CA 92780 INSURERIS AFFORDING COVERAGE NAIL#
<br /> INSURER A: Everest Premier Insurance Comp 16045
<br /> INSURED AJFfS-1 INSURER B:Great American Insurance Com p a 16691
<br /> A.J. Fistes Corporation 1244 N. Gaffey Street INSURERC:IGeneral Insurance Cor or 20095
<br /> San Pedro CA 90731 INSURER D:
<br /> INSURER E
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER:1809987216 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 I POLICY EXP
<br /> IPOLICY NUMBER MMIDD)YYYY MMIODlYYYY LIMITS
<br /> C X COMMERCIAL GENERAL LIABILITY Y CLP3749664 1014/2024 6/3012025 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE I X I OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrent® S 100,000
<br /> MED EXP(Any One person) S 5,000
<br /> PERSONAL&ADV INJURY 52,000,D00
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY PRO-
<br /> JECT D LOC
<br /> PRODUCTS-COMPlOP AGG $2,040,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY Y CAP3749663 10)4I2024 6/30/2025 COMBINED SINGLE LIMIT $2,000,000
<br /> Ea acciden€
<br /> ANY AUTO BODILY INJURY(Per person) S
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY( )
<br /> Per accident $
<br /> HIRED NON-OWNED -PROPERTY DAMAGE $
<br /> X1AUTOS ONLY AUTOS ONLY Per act€dent
<br /> H I COmPICOII Ded. $1,000
<br /> B UMBRELLA N OCCUR EXC5201094 4/19/2024 6/3012025 EACH OCCURRENCE $7,000,000
<br /> X EXCESS LIAR CLAIMS-MADE
<br /> AGGREGATE $7,000,000
<br /> DIED RETENTION$ 3
<br /> A WORKERS COMPENSATION Y 7600023383241 6/30/2024 6/30/2025 X I
<br /> SEATUTE ERH AND EMPLOYERS'LIABILITY Y)N
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBER EXCLUDED? D N!A
<br /> (Mandatary 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 /> DESCRIPTION OF OPERATIONS f LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:Agreement Nos.A-2017-172 and A-2017-290,SARTC Painting
<br /> The City of Santa Ana, its officers,employees,agents,and representatives are included as Additional Insured with respect to General and Auto Liability if
<br /> required by written contract and subject to terms,conditions and exclusions of the policy.Coverage is provided on a Primary&Non-Contributory basis On
<br /> General and Auto Liability if required by written contract and subject to terms,conditions and exclusions of the policy.A Waiver of Subrogation in favor of The
<br /> City of Santa Ana,its officers,employees,agents,and representatives applies to Workers Compensation if required by written contract,and subject to terms,
<br /> conditions,and exclusions of the policy.30-day notice of cancellation,except for nonpayment of premium.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Cynthia Mora at 11:43 am,Dec 13, 2024
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702
<br /> c01988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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