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CERTIFICATE OF LIABILITY INSURANCE <br />DATE (M <br />W024YYY) <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 />CONTACT <br />NAME: Maurice Thornton <br />AssuredPartners Design Professionals Insurance Services, LLC <br />PHONN <br />3697 Mt. Diablo Blvd., Suite 230 <br />E . 510-272-1476 ac Na <br />fAIC.E-MAIL <br />ADDREss: Desi nProCerts AssuredPartners.com <br />Lafayette CA 94549 <br />INSURERS AFFORDING COVERAGE <br />NAIL# <br />INSURER A: Travelers Casualty <br />and Surety Co of America <br />31194 <br />LicenseM fiQQ3745 <br />INSURED AKMCONS-01 <br />INSURER B: Fla <br />I I <br />29424 <br />. <br />553 Wald Street <br />AKM Consulting Engineers, InAngieA <br />a rd UnderM riters Insurance Company <br />30104 <br />Irvine CA 92618-4627 n g i e c ev <br />s <br />INSURER F.: .10.07 <br />f <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER:457903049 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 />TYPEOFINSURANCE111M <br />ADDLSUBR <br />-WA <br />POLICY NUMBER <br />POLICY EFF <br />MM/DDYYYY) <br />POLICY UP <br />(MWDDNYYYI <br />LIMITS <br />C <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />Y <br />Y <br />57SBWBE3FCJ <br />9/20/2024 <br />9120/2025 <br />EACH OCCURRENCE <br />$2,000,000 <br />ETORENTED <br />PREMI <br />PREMISES Ea occurrencel <br />$1,000,000 <br />MED UP (Any one person) <br />$10,000 <br />PERSONAL S ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE <br />LIMIT APPLIES PER: <br />POLICY E PEA FILOC <br />GENERAL AGGREGATE <br />$4,000,000 <br />PRODUCTS-COMP/OP AGO <br />$4,000,000 <br />$ <br />OTHER: <br />C <br />AUTOMOBILE <br />LIABILITY <br />Y <br />Y <br />57SBWBE3FCJ <br />9/20/2024 <br />9/20/2025 <br />COMBINED SINGLELIMIT <br />Ea accident <br />$2,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCAUTHEDULED <br />AUTOS ONLY OB <br />BODILY INJURY (Per accident) <br />$ <br />X <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />C <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />Y <br />Y <br />57SBWBE3FCJ <br />9/20/2024 <br />9/20/2025 <br />EACH OCCURRENCE <br />$3,000,000 <br />AGGREGATE <br />$3.000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DEO I X RETENTION <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERVLIABILITY Y/N <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBEREXCLUDED7 <br />NIA <br />V <br />57WEGZS0250 <br />9/20/2024 <br />9/20/2025 <br />X STATUTE ERH <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />(Mandatoryin NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />i <br />E.L. DISEASE -POLICY LIMIT <br />$1'000.000 <br />A <br />Professional Liability <br />105344511 <br />9/20/2024 <br />9/20/2025 <br />Per Claim <br />$2,000,000 <br />Aggregate Limit <br />$4,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace Is required) <br />Insured owns no company vehicles; therefore, hired/non-owned auto is the maximum coverage that applies. <br />The Umbrella Policy is follow form to its underlying Policies: General Liability/Auto Liability/Employers Liability. <br />RE: On -Call Construction Management Services. The City of Santa Ana, its officers, officials, employees, and volunteers are named as additional Insured for <br />General Liability and Auto Liability as required per written contract. General and Auto Liability are Primary/Non-Contributory per policy form wording. A <br />Severability of Interests Clause applies to General Liability per policy form. Insurance coverage includes waiver of subrogation per the attached <br />endorsement(s). CANCELLATION: 30 day notice will be sent to the certificate holder. <br />TE <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 ACCORDANCE WITH THE POLICY PRC <br />Risk Management Division RbkAfo.gon etDMdar <br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE 61 REVIEWEO&APPRoveoft <br />Santa Ana, CA 92702 ^, 71 <br />�yx I Risk Management Sped alist <br />©1988-2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />