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AC 8 DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 01/08/2025
<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 rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Erica Hornaday
<br /> NAME:
<br /> The Empire Company PHONE FAX
<br /> A/C No Ext: (A/C,No):
<br /> 550 North Park Center Drive E-MAIL ADDRESS: ehornaday@empire-co.com
<br /> Suite 205 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Santa Ana CA 92705 INSURERA: Hartford Underwriters Insurance Company 30104
<br /> INSURED INSURERB: Trumbull Insurance Company 27120
<br /> RSG,Inc. INSURERC: Berkley Assurance Company 39462
<br /> 170 Eucalyptus Avenue INSURER D:
<br /> Suite 200 INSURER E:
<br /> Vista CA 92084 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 25-26 MASTER 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 MAYBE 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 INSURANCEALMLIbULSKI POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY) (MM/DDIYYYYI LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO RENTED 1,000,000
<br /> CLAIMS-MADE X OCCUR PREMISES Ea occurrence $
<br /> MED EXP(Any one person) $ 10,000
<br /> A Y Y 72SBABHIDMT 01/01/2025 01/01/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PEA LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER. $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED 72SBABHIDMT 01/01/2025 01/01/2026 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> IX
<br /> HIRED �/ NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY /� AUTOS ONLY Per accident
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> A EXCESS LIAB CLAIMS-MADE 72SBABHIDMT 01/01/2025 01/01/2026 AGGREGATE $ 2,000,000
<br /> DED I X RETENTION$ 10,000 $
<br /> WORKERS COMPENSATION X STATUTE EORH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> B OFFICER/MEMBER EXCLUDED? NIA Y 72WECVK8727 01/01/2025 01/01I2026
<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 $
<br /> ERRORS&OMISSIONS AGGREGATE LIMIT 1,000,000
<br /> C CLAIMS MADE VUMB0161147 11/13/2024 11/13/2025 EACH CLAIM 1,000,000
<br /> DEDUCTIBLE 10,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> [Job#:WC WOS Job Type:Al PNC WOS]
<br /> RE:RFQ No.21-107 Affordable Housing Financial,Analytical And Advisory Services-Evidence of Renewal of Insurance applies to agreement dated
<br /> 9/6/2024.City of Santa Ana,its officers,officials,employees,and volunteers are named as additional insured on this policy pursuant to written contract,
<br /> agreement,or memorandum of understanding.Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be
<br /> excess and non-contributory under the General Liability,where required by written contract,per form(SS 00 08 04 05)and(SS 00 08 04 05).General
<br /> Liability is Primary and Non-Contributory per form(SS 00 08 04 05).General Liability and Worker's Compensation Waiver of Subrogation per forms(SS 00
<br /> 08 04 05)and(WC 04 03 06).`30 day notice of cancellation applies.
<br /> CERTIFICATE HOLDER CANCELLATION APPROVED
<br /> By Cynthia Mora at 3:03 pm, Jan 14, 2025
<br /> SHOULD ANY OF THE A
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> AUTHORIZED REPRESENTATIVE
<br /> (M-28)
<br /> Santa Ana CA 92702
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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