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VIDOSAM-01 JCHRISTIANSON
<br />s��l2O' CERTIFICATE OF LIABILITY INSURANCE
<br />DAM
<br />1/312 D/YYYY)
<br />1 /3/2025
<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 endorsements .
<br />PRODUCER
<br />CONTACT
<br />HUB International Insurance Services Inc.
<br />4695 MacArthur Court
<br />PA"ic°°,"ri ,Eae: (949 553-9800 FAX
<br />) wc, No:
<br />EADpAIL
<br />Suite #600
<br />Newport Beach, CA 92660
<br />INSURERS AFFORDING COVERAGE
<br />NAIC It
<br />INSURER A: The Travelers Indemnity Company of America
<br />25666
<br />INSURED
<br />INSURER B:AmTrust Insurance Company
<br />15954
<br />INSURER c:Navigators Specialty Insurance Company
<br />36056
<br />Vido Samarzich, Inc.
<br />INSURER D:
<br />6829 Billings PI
<br />Rancho Cucamonga, CA 91701--4923
<br />INSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER- RFVISIfNU rdnuoao-
<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 LTRTYPE
<br />OF INSURANCE
<br />ADOL
<br />SUER
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />O
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE Fv� OCCUR
<br />X
<br />X
<br />4T-CO-A7193762-TCT-25
<br />1/1/2025
<br />1/1/2026
<br />EACH OCCURRENCE
<br />1,000,000
<br />DAMAGE TO RENTED
<br />$ 300,000
<br />MED EXP (Any one eison
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />1 1,000,000
<br />GEN'L
<br />X
<br />AGGREGATE LIMITAPPLIES PER:
<br />POLICY ❑ JEST LOG
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS -COMPIOP AGG
<br />21000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />EON18. ad1NED dentiSINGLE LIMIT
<br />ll 11000ggg
<br />X
<br />BODILY INJURY Perperson)
<br />$
<br />ANYAUTO
<br />OWNED ISCHEDULED
<br />AUTOS ONLY AUTOS
<br />X
<br />X
<br />BA-A7193608.25-2S-G
<br />1/1/2025
<br />1/1/2026
<br />BODILY INJURY Per accident
<br />PROPERTY DAMAGE
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY(PmeccidenF
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />CUP-A7193842-25-2S
<br />111/2025
<br />1/1/2026
<br />DED X RETENTION$ 10,000
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNEWEXECUTIVE Y/"
<br />FFICERIMEMBER EXCLUDED? Y❑
<br />Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below I
<br />NIA
<br />X
<br />CTP7003323
<br />1/1/2025
<br />111/2026
<br />X IPER OTH-
<br />ER
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYE
<br />1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />1 11000,000
<br />C
<br />Umbrella Liability
<br />LA25EXCZOK6PLIC
<br />1/1/2025
<br />1/1/2026
<br />Each OccJAgg.
<br />3,000,000
<br />A
<br />Leased/Rented Equip.
<br />4T-CO-A7193762-TCT-25
<br />1/112025
<br />1/1/2026
<br />Limit
<br />125,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1Di, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: Project #22-1342; 10th Street & Flower Improvements. glaipwv/auaiwv/wcwv
<br />City of Santa Ana, its officers, officials, employees, and volunteers are included as Additional Insureds as respects General Liability and Auto Liability per
<br />attached endorsements.
<br />This Insurance shall apply as Primary and Non -Contributory per attached endorsement.
<br />Waiver of Subrogation for General Liability, Auto Liability and Workers' Compensation: See Attached Endorsements.
<br />AgahL
<br />r � nvw�rc
<br />City of Santa Ana
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<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 PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACUKU 20 (ZU1 b/U31 © 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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