|
ACORO�' CERTIFICATE OF LIABILITY INSURANCE
<br />'111
<br />DATE(MM/ODYVVY)
<br />2n/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 endorsement(s).
<br />PRODUCER
<br />Burnham Risk & Insurance Solutions
<br />15901 Red Hill Ave, Ste 100
<br />Tustin CA 92780
<br />CONTACT
<br />NAME: Charlotte Mercer
<br />PHONNo,E . 714-439-3581 ac No:714-573-1770
<br />aooness: charlotte.mercer w bib.com
<br />INSURERS AFFORDING COVERAGE
<br />NAICR
<br />INSURER A: Great American Insurance Com a
<br />16691
<br />Ucensu OF69771
<br />INSURED HARD&HA-02
<br />Hardy & Harper, Inc.
<br />Inc.
<br />32 Rancho Circle
<br />INSURER B : BITCO National Insurance Com a
<br />20109
<br />INSURER C: Great American Excess & Sur lu
<br />37532
<br />INSURER D :
<br />Lake Forest CA 92630
<br />INSURER E
<br />NSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 1456340530 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 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
<br />LTR
<br />TYPEOFINSURANCE
<br />ADDL
<br />1=
<br />SUBR
<br />MDPOLICYNUMBER
<br />POLICY EFF
<br />MMIDDNYYV)
<br />POLICY EXP
<br />fMM!DD1YYYYI
<br />LIMITS
<br />B
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADEIT] OCCUR
<br />Y
<br />Y
<br />CLP3742815
<br />4/15/2024
<br />4/15/2025
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES i occurrence
<br />$100,000
<br />MED EXP (Any oneperson)
<br />$5,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GENL
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY JE� LOG
<br />GENERALAGGREGATE
<br />$2,000,000
<br />PRODUCTS-COMP/OP AGO
<br />$2,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />V
<br />CAP3742814
<br />4/15/2024
<br />4/15/2025
<br />Ea eBINED SINGLE -LIMIT
<br />$1,000,000
<br />X
<br />BODILY INJURY (Per parson)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLYMAUTOS
<br />HIRED NON-OWNEDPROPERTYDAMAGEAUTOS ONLYAUTOS ONLY
<br />BODILY INJURY Per accident
<br />( I
<br />$
<br />X
<br />Per oxidant
<br />$
<br />A
<br />MBRELLA LIAB
<br />X
<br />OCCUR
<br />TUE 4369837-02
<br />4/15/2024
<br />4/15/2025
<br />EACH OCCURRENCE
<br />$2,000,000
<br />4XEXCESS
<br />AGGREGATE
<br />$2,000,000
<br />LIAB
<br />CLAIMS -MADE
<br />ED RETENTION$
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANVPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBEREXCLUDED?
<br />N/A
<br />Y
<br />WC 3 743 729
<br />4/15/2024
<br />4/15/2025
<br />X STATUTE EOq
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1.000,000
<br />(Mandatory in Ni
<br />If yes, describe under
<br />E.L. DISEASE- POLICY LIMIT
<br />$1,oao,000
<br />DESCRIPTION OF OPERATIONS below
<br />C
<br />Professional Liability
<br />Pollution Liability
<br />PCM E502853 04
<br />4/15/2024
<br />4/15/2025
<br />Each Occurrence
<br />Annual Aggregate
<br />1,000,000
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />General Liability Additional Insured, Primary and Noncontributory, and Waiver of Subrogation applies per attached endorsements. General Liability Aggregate
<br />limit per project applies per attached endorsements. Auto Liability Additional Insured, Primary and Noncontributory, and Waiver of Subrogation applies per
<br />attached endorsements. Work Comp Waiver of Subrogation applies per endorsement WC040306. 30 day Notice of cancellation applies per attached
<br />endorsements.
<br />RE: Project # 25-6711 Civic Center Rehabilitation
<br />The City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers are included as Additional Insured as respects General Liability per
<br />attached endorsement.
<br />A
<br />CERTIFICATE HOLDER APPROVED CANCELLATION
<br />By Tu Train Nguyen at 12:09 pm, Feb 07, 2025y
<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 Tu TranepO„ gnee ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attention: Public Works Agency Nguye
<br />20 Civic Center Plaza, M-22
<br />1E_s9ear AUTHORIZED REPRESENTATIVE
<br />n
<br />Santa Ana CA 92701
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|