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ACORD® DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 11/19/2024
<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 w� p y, 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). d
<br /> PRODUCER CONTACT •O
<br /> NAME:
<br /> ADD Risk Services Central, Inc. PHONE FAX
<br /> St. Louis MO Office (A/C.No.Ext): (866) 283-7122 (A c.No.). (800) 363-0105
<br /> 4220 Duncan Avenue E-MAIL 2
<br /> Suite 401 ADDRESS:
<br /> St Louis MO 63110 USA
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURED INSURER A: 3ames River Insurance Company 12203
<br /> Shade Structures, Inc. INSURER B: Pennsylvania Manufacturers' Assoc Ins Co 12262
<br /> USA SHADE & FABRIC STRUCTURES
<br /> 2580 Esters Blvd., Suite 100 INSURERC: Manufacturers Alliance Ins Co 36897
<br /> DFw Airport, Tx 75261 USA INSURERD: Columbia Casualty Company 31127
<br /> INSURER E: Allied world Assurance Company (US) Inc 19489
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 570109483131 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 MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> Limits shown are as requested
<br /> INSR ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 000959655 10/01/2024 10/01/2025 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED $300'000
<br /> PREMISES(Ea occurrence)
<br /> X XCU not exd MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> N'LAGGFIEG-E LIMITAPPLIES PER: GENERAL AGGREGATE $2,000,000 M
<br /> POLICY PRO do
<br /> JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 0
<br /> OTHER: o
<br /> r`
<br /> B AUTOMOBILE LIABILITY Y Y 152400 0652321A 10/01/2024 10/01/2025 COMBINED SINGLE LIMIT
<br /> AUtO ADS (Ea accident) $1,000,000
<br /> C J ANY AUTO Y Y 152400 0652321B 10/01/2024 10/01/2025 BODI LY I NJURY(Per person) ••
<br /> O
<br /> OWNED
<br /> SCHEDULED Auto CA BODI LY I NJURY(Per accident) Z
<br /> AUTOS ONLY AUTOS N
<br /> HIREDAUTOS NON-OWNED PROPERTY DAMAGE I O
<br /> ONLY AUTOS ONLY (Per accident)
<br /> -C
<br /> 11
<br /> d7
<br /> E X UMBRELLA LIAB OCCUR 03140086 10/01/2024 10/01/2025 EACH OCCURRENCE $5,000,000 U
<br /> X
<br /> EEXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
<br /> ED I X RETENTION $10,000
<br /> B WORKERS COMPENSATION AND Y 2024750652321 10/01/2024 10/01/2025 x PER STATUTE OTTH-
<br /> EMPLOYERS'LIABILITY
<br /> YIN
<br /> JER
<br /> ANY PROPRIETOR/PARTNER/ N/A E.L.EACH ACCIDENT $1,000,000
<br /> EX N
<br /> ECUTIVE OFFICER/MEMBER
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If y s,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: City's Newhope Library ("Project''), 122 N. Newhope St. Santa Ana, CA 92703. The per location aggregate is subject to a
<br /> policy cap of $10,000,000. The General Liability (ongoing & Completed operations) and Automobile Liability include a blanket
<br /> Additional Insured endorsement in favor of City of Santa Ana, its officers, officials, employees and volunteers that provides
<br /> this feature only when there is a written contract with the named insured that requires such status. General Liability
<br /> insurance is primary and non-contributory. The General Liability, Automobile Liability and workers' Compensation policies x
<br /> include a blanket waiver of Subrogation endorsement in favor of City of Santa Ana that provides this feature only when there i
<br /> a written contract with the named insured that requires such status. Umbrella Liability policy follows form. IN
<br /> CERTIFICATE HOLDER CANCELLATION M9
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br /> DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. _
<br /> city of Santa Ana AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza
<br /> Santa Ana CA 92702 USA Far
<br /> ACORD 25(2016/03) The ACORD name and logo are registere APPROVED
<br /> By Cynthia Mora at 12:41 pm, Dec 10, 2024
<br />
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