Laserfiche WebLink
ACC:)Rbr CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MWDDIYYVY) <br />8/19/2024 <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 />Venbrook Insurance Services <br />6320 Canogga Avenue, 12th Floor <br />Woodland Nills, CA 91367 <br />CONTACT <br />NAME: Venbrook Insurance Services <br />PHONE <br />N E 818-598-8900 ac No: 818-598-8910 <br />E-MAIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE NAICR <br />www.venbrook.com C///A���LLaaicliNo. OD808 <br />INSUR A: C'o I r n RIb`�kp��y�,V MMA <br />INSURED n g I C �\ / <br />Cannon Corporation V <br />1050 Southwood Drive <br />E.10 <br />R : -zrdor asual Insur nce Com an A+) 29424 <br />s U a Ira . A - 0 <br />INSURER. O: <br />San Luis Obispo CA 93401 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMRFR• Ql AR99PR OCVICInM MI IMRCO. <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 />INSD <br />SON <br />WD <br />POLICYNUMBER <br />POLICY EFF <br />MWDD/YYY <br />POLICY EXP <br />MMIDDNYYY <br />LIMITS <br />A <br />�/ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ✓ OCCUR <br />✓ <br />�/ <br />7039996776 <br />9/1/2024 <br />9/1/2025 <br />EACH OCCURRENCE <br />$1 000000 <br />PREMISESEa occ ED <br />PREMISES Ea owurrenr» <br />$100 000 <br />✓ <br />MED EXP (Any one person) <br />$15 000 <br />Contractual Liability <br />PERSONAL&ADV INJURY <br />$1 000 000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY Z JECT M LOC <br />GENERALAGGREGATE <br />$2,000,000 <br />PRODUCTS-COMP/OP AGG <br />$2000000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />✓ <br />✓ <br />BUA 7040001609 <br />9/1/2024 <br />9/1/2025 <br />T <br />Ed accidW <br />$j 000000 <br />✓ <br />BODILY Ison) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY Iident ) <br />$ <br />✓ <br />HIRED <br />AUTOS ONLY ✓ AUTOS ONLY <br />PaDacc,d$ <br />✓ <br />$A <br />Com /Coll De Let his 1 000 <br />� <br />UMBRELLA LIAB <br />✓ OCCUR <br />✓ <br />✓ <br />CUE 7040002176 <br />9/1/2024 <br />9/1/2025 <br />EACH OC$9000000EXCESS <br />AGGREG$ <br />9 000 000 <br />LIAB <br />CLAIMS -MADE <br />DEO I ✓ RETEMION 10,000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANVPROPRIETOR/PARTNEWEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />N/A <br />✓ <br />72 WE OL6HIH <br />9/1/2024 <br />9/1/2025 <br />✓ SPER <br />TATUTE OER <br />E.L. EACH ACCIDENT <br />$1000000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1 <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />I $1000000 <br />DESCRIPTION OF OPERATIONS below <br />I <br />C <br />Professional/Pollution Liability <br />C27737240601 <br />9/1/2024 <br />9/1/2025 <br />$5,000,000 Per Claim/$5,000,000 Aggregate <br />Deductible: $100,000 Each Claim incl exp <br />A <br />Equipment Leased Borrowed or Rente <br />7039996776 <br />9/1/2024 <br />9/1/2025 <br />$125,000 Limit; $1,000 Deductible <br />A <br />Contractors E ui ment - Scheduled <br />7039996776 <br />9/1/2024 <br />9/1/2025 <br />534 309 Limit; $2,500 Deductible <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: City of Santa Ana- On -Call Construction Management and Inspection Services - 23-122- Cannon # 230719 <br />"SEE ATTATCHED ADDENDUM"' <br />Celt of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br />P. Box 1988 ACCORDANCE WITH THE POLICY PRE <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <br />AUTHORIZED REPRESENTATIVE REViEWED&AFPRavEDBY: <br />A+J:r Aedo4to <br />I�. Karen Smith Risk Marla Bement Specialist <br />©1988-2015 ACORD <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />81452588 1 24-25 GL/AL/WC/W/PL I Karen Smith 1 8/19/2024 1:32,46 PM (PDT) I Page 1 of 13 <br />