|
AWPINCO-01 EMCGAUGHEY
<br />,aI� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE 211
<br />912024
<br />12/1912024
<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 />Schauer 200 Market Ave. Nc.
<br />Suite 100
<br />PHONE ) FAX No:(330) 453-4911
<br />(A/C, No, Exq: (330 453-7721
<br />E-M Riess: insure@schauergroup.com
<br />Canton, OH 44702
<br />INSURERS AFFORDING COVERAGE
<br />NAIC p
<br />INSURER A: Continental Casual CNA
<br />20443
<br />INSURED
<br />Statewide Traffic Safety & Signs, Inc. dba Statewide Safety
<br />Systems
<br />INSURER B: American CasualtyCompany of Reading PA
<br />120427
<br />INSURER C: Landmark American Insurance
<br />33138
<br />INSURER D:
<br />522 Lindon Lane
<br />INSURER E:
<br />Nipomo, CA 93444
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSft
<br />TYPE OF INSURANCE
<br />ADDLSUB0.
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL L[ABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />X
<br />7063813872
<br />1/112025
<br />1/112026
<br />EACH OCCURRENCE
<br />2,000,000
<br />DAMAGE TO RENTED
<br />PREMISES ccurr
<br />1,000.000
<br />MED UP (Any one mon
<br />10,000
<br />PERSONAL& ADV INJURY
<br />2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY [XI Toa 71 LOC
<br />GENERALAGGREGATE
<br />4,000,000
<br />PRODUCTS - COMP/OP AGG
<br />1 4,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />O
<br />OWNED
<br />OWNED SCHEDULED AUTOS ONLY AlfT05
<br />X
<br />X
<br />7063823186
<br />1/1/2025
<br />111/2026
<br />COMBINED SINGLE LIMIT
<br />em
<br />BODILY INJURY Per person
<br />2,00X0,000
<br />X
<br />BODILY INJURY Per accident
<br />X
<br />ROPERTY AMAGE
<br />Per accident
<br />HIRED )( NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />A
<br />X
<br />UMBRELLALIAB
<br />EXCESS LIAR
<br />X
<br />OCCUR
<br />CI -AIMS -MADE
<br />X
<br />X
<br />7063731480
<br />111/2025
<br />1/112026
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,000
<br />TIED RETENTION$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICEWMEMSE�E%CLUDED? ❑N
<br />lMaudatory In NH
<br />If Yes, describe under
<br />DESCRIPTION OF OPERATIONSbelow
<br />NIA
<br />X
<br />7063820771
<br />1/112025
<br />1I112026
<br />X I PER OTH-
<br />STARTE E
<br />E.L. EACHACCIDENT
<br />1�gpp�ggg
<br />E.L DISEASE - EA EMPLOYE
<br />1,000,000
<br />E.L.DISEASE-POLICY LIMB
<br />1,000,000
<br />C
<br />Professional Liabili
<br />44
<br />LHC8636
<br />11112025
<br />1/1/2026
<br />Each Claim
<br />2,000,000
<br />C
<br />Pollution Liability
<br />LHC863446
<br />1/112025
<br />1/112026
<br />Limit
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES ((ACORD 101, Additional Remarks Schedule, me be adached If more space is re ulred))
<br />Workers Comp Policy #7063820711 is for AL, CO, CT, DC, FL, GA, HI, ID, IN, KY, LA, I�1D, MI, MS, NV, NJ, NM, N%, NC, OK, PA, SC, TN, TX, UT, VA, WV; AZ, MA,
<br />OR, VT, WI Policy #WC 7 63820465; CA Policy #7 63819574; NO, OH, WA, WY Stop Gap Policy #7063813905
<br />Re: Professional traffic control services
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives is/are included as additional insured where required by written contract
<br />with respect to general liability and auto liability. This insurance is primary and non-contributory over all other insurance where required by written contract.
<br />Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions. Umbrella is follow form of primary, subject
<br />SEE ATTACHED ACORD 101
<br />City of Santa Ana
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<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
<br />HU VRU LJ ILU I O/USI U 1983-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|