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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MLVDDNYYY)
<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 LOckton Insurance Brokers, LLC
<br />777 S. Figueroa Street, 52nd Fl.
<br />CA License #OF15767
<br />Los Angeles CA 90017
<br />(213)689-0065
<br />_
<br />uunigt,l
<br />NAME:
<br />PHONE FAX
<br />Ext : A/C No ;
<br />E MAIL
<br />A E `
<br />I c G
<br />N.C.
<br />INSURER
<br />rum c ster e a nsurance Co
<br />44520
<br />INSURED Rincon Consultants,
<br />180NAshwoodAve
<br />Ventura CA 93003 yyIv
<br />IN C
<br />) •NsuRER D :� aomar
<br />e Cam arl
<br />terInnurance Company
<br />xcess and Surplus Insurance Co.
<br />196821462718
<br />42471
<br />16754
<br />COVERAGES RINC001 /\ CWMFAftTi NWOPM: i.IL SA91a9 r
<br />... .RiShUSIONALMRER- XYXI'YYY
<br />IS IS TO
<br />ERTIFY THAT
<br />INDICATED. CATED.CNOTWITHSTAN H G A I S O IE T I1ii� B ,IIfQMOEN1 1 Cn Lt R (S M Nt 10 RESPECFOR T TOLICY WHICH PERIOD
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURA.NC . AFFORDED BY HE OLICIES DE CRIBED HEREI I SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SPJW'. MAY HAVE BE C `f I LAI 1 L
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUER
<br />r AICY NUMBER
<br />MM/OD/YYYY
<br />2/1/2023
<br />MM/DDy EX
<br />2/l/2025
<br />UNITS
<br />EACH OCCURRENCE
<br />$ 3,000,000
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />Y
<br />Y
<br />_
<br />EPK-142587
<br />DAMAGE 10 RENTED
<br />PREMISES Ea occurrence
<br />$ 100 00O
<br />X
<br />MED EXP (Any one person)
<br />$ 10,000
<br />SIR: $50,000
<br />X
<br />P&I
<br />PERSONAL & ADV INJURY
<br />$ 3,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY F JECT LOC
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />PRODUCTS-COMP/OP AGO
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />E
<br />AUTOMOBILE
<br />LIABILITY
<br />y
<br />y
<br />72UENOL5481
<br />2/l/2024
<br />2/1/2025
<br />EeeBBINtutslNGLE LIMIT
<br />$ 1000000
<br />BODILY INJURY (Per person)
<br />$ XXXXXXX
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />Ix
<br />BODILY INJURY Per accident
<br />( )
<br />$ XXXXXXX
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTYoAMAGE
<br />Per accident
<br />$ XXXXXXX
<br />Cnmn Irnll. D
<br />$ 1,000
<br />C
<br />D
<br />UMBRELLA UAB
<br />EXCESSLU1B
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />N
<br />N
<br />EFX-119720
<br />EVEQ-0000005
<br />2/l/2024
<br />2/1/2024
<br />2/1/2025
<br />2/1/2025
<br />EACH OCCURRENCE
<br />$ 10000000
<br />X
<br />AGGREGATE
<br />$ 10000000
<br />DED X RETENTION $ 10,000
<br />$ j 'N)0 i{XX
<br />E
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'UABIUTY Y/N
<br />ANY PROPRIETOWPARTNER/EXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? ❑N
<br />NIA
<br />y
<br />T10220329
<br />2/1/2024
<br />2/1/2025
<br />PER OTH-
<br />X STATIfiE ER
<br />E.L. EACH ACCIDENT
<br />$ 1.000000
<br />EL DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, distance under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1000000
<br />A
<br />Contractors Pollution Liab
<br />E&O Liab.
<br />N
<br />N
<br />EPK-142587
<br />2/l/2023
<br />2/1/2025
<br />Limit: $3,000,000/$4,000,000
<br />Limit: $3,000,000/$4,000,000
<br />Reno Date: 12/9/1994
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mom space is required)
<br />Effective 2/I/2024-8/l/2025, Cyber Liability $5M Limit, $25k Retention, Carrier: RCC; Policy #H24NGP224923-01, 55M x $5M Limit, Carrier: Comas, Policy #CXS-107946155-00. The City of
<br />Santa Ana and Community Development Agency and their officers, employees, agents and volunteers are an Additional Insured to the extent provided by the policy language or endorsement issued or
<br />approved by the insurance carrier. Waiver of Subrogation applies per attached endorsement(s) or policy language. Insurance provided to Additional Insured(s) is primary and non-contributory, as per the
<br />attached endorsement or policy language. Excess policy follows General Liability, Auto Liability and Employers Liability form. Notice of Cancellation applies per the applicable policy language or
<br />endorsements.
<br />16059509
<br />City of Santa Ana
<br />Risk Management Divison
<br />20 Civic Center Plaza, 4th Floor
<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 PR(
<br />AUTHORIZED REPR �� REVIEWED ✓y APPROVED BY:
<br />r�� A�rAuw�o
<br />�� Risk Management SpeOalist
<br />ACORD 25 (2016103)
<br />©1988-201 S'AC
<br />The ACORD name and logo are registered marks of ACORD
<br />
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