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ACORO® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (/22120 )
<br />�i
<br />nlzzlzoz4
<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 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
<br />CONTACT Tina Cowie
<br />Ni
<br />Cornerstone Specialty Insurance Services, Inc.
<br />PN0NE (714) 731-770D FAX (714) 731-7750
<br />E Xtn No :
<br />14252 Culver Drive, A299
<br />E-MAIL tina@cornerstonespeclalty.com
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICN
<br />Irvine CA 92604
<br />INSURER A; RLI Insurance Company
<br />13056
<br />INSURED
<br />INSURER B; Aspen American Insurance Company
<br />43460
<br />BOAARCHITECTURE
<br />INSURER C:
<br />1511 Cota Avenue
<br />INSURER D:
<br />INSURER E :
<br />Long Beach CA 90813
<br />INSURERF:
<br />COVERAGES CERTIFICATE NUMBER: 24125 COVERAGES 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
<br />POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN
<br />REDUCED BY PAID CLAIMS.
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />MD
<br />POLICY NUMBER
<br />MMIDDIYYYY
<br />MMMD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIALGENERALLIABILrrY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE © OCCUR
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />MED EXP (An one porsoN
<br />$ 10,000
<br />ADDT'L INSURED / P & NC
<br />XBLNKTWVROFSUBRO
<br />INCLUDED
<br />A
<br />Y
<br />Y
<br />PSBOOD7999
<br />11/20/2024
<br />11/20/2025
<br />PERSONAL &ADV INJURY
<br />$
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 4,000,000
<br />POLICY ® JECOT LOC
<br />PRODUCTS - COMP/OP AGO
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />To accident
<br />$ 2,000,000
<br />BODILY INJURY (Par person)
<br />$
<br />ANYAUTO
<br />q
<br />OWNED SCHTOSEDULED
<br />AUTOS ONLY AU
<br />Y
<br />Y
<br />PSB0007999
<br />11/20/2024
<br />11120/2025
<br />BODILY INJURY(PefeccldenU
<br />$
<br />HIRED v NON -OWNED
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />AUTOS ONLY AUTOS ONLY
<br />$
<br />X
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />EXC58SLIAa
<br />CLAIMS -MADE
<br />Y
<br />Y
<br />PSE0003983
<br />11/20/2024
<br />11/20/2025
<br />AGGREGATE
<br />$ 1,000.000
<br />DED I I RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />vl PER OTH-
<br />AND EMPLOYERS' LIABILITY YIN
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />A
<br />ANYPROPRIETORlEXCLUD (EXECUTIVE
<br />N/A
<br />Y
<br />PSW0004454
<br />11/20/2024
<br />11120/2025
<br />F nd to , In NHR EXCLUDED?
<br />(Mandator,
<br />( ry )
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />DESCRIPTIOify�, describeN under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L, DISEASE-POLICYLIMIT
<br />$ 1,000,000
<br />Each Claim
<br />$4,000,000
<br />Professional Liability
<br />B
<br />Claims Made
<br />AAAE100264-06
<br />11/20/2024
<br />11/20/2025
<br />AnnualA re
<br />Aggregate
<br />9
<br />$4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule,
<br />may be attached It more space Is requlmd)
<br />Re: Agreement No. A-2020-230-03
<br />The City of Santa Ana, its officers, officials, employees, and volunteers are Additional Insured for General Liability & Non -owned and Hired Auto Liability, on
<br />primary/non-contributory basis, but only if required by written contract with the Named Insured
<br />prior to an occurrence and as per attached endorsement.
<br />Coverage Is subject to all policy terms and conditions. 30 days Notice of Cancellation *Except 10 days Notice of Cancellation for non-payment of premium.
<br />For Professional Liability coverage, the aggregate limit is the total insurance available for all covered claims reported within the policy period.
<br />APPROVED
<br />CERTIFICATE HOLDER
<br />CANCEL By_Cynihia_MDra_at__2-1:5fi am, -Dec 91,_= '
<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 Risk Management Division
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702
<br />,
<br />91988.2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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