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DATE(MWDDIYYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 1/9/2025
<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 GUNIAGI
<br /> NAME; Alexander Russell
<br /> Premier Associates Insurance Brokers PHONE 949 800-5003
<br /> ) (AIC,No):
<br /> 3931 BIRCH ST. ADDRESS: alex(a,prcmieroc.com
<br /> STE.,B INSURER(S)AFFORDING COVERAGE NAIC#
<br /> NEWPORT BEACH CA 92660 INSURERA: BERKLEY ASSUR CO 39462
<br /> INSURED INSURER B: STARSTONE SPECIALTY INS CO 44776
<br /> Triangle Decon Services,Inc. INSURER C: UNITED FINANCIAL CA.CO 11770
<br /> 25422 ADRIANA ST INSURER D: CALIFORNIA STATE COMPENSATION FUND 35076
<br /> INSURER E
<br /> MISSION VIEJO CA 92691-3920 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 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 /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER
<br /> X COMMERCIAL GENERAL LIABILITY (MMIDDIYYYY) (MMlDDfYY'YY) LIMITS
<br /> EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 100,000
<br /> MED EXP(Any one person) S 5.000
<br /> A Y Y VUMD0365420 09/22/2024 09/22/2025 PERSONAL t.ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000
<br /> POLICY ❑PRO- -
<br /> JECT LOC PRODUCTS-COMPIOP AGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY
<br /> (Ea accidenq '$ I,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> C OWNED y SCHEDULED 973762079 09/22/2024 09/22/2025 BODILY INJURY(Per accident AUTOS ONLY �A AUTOS ) $
<br /> v HfRED NON-OWNED
<br /> A AUTOS ONLY A AUTOS ONLY {Per accident) $
<br /> x UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> B EXCESSLIAa CLAIMS-MADE 84581V24IALI 09/2212024 09/22/2025 AGGREGATE 3 2,000,000
<br /> DEb I I RETENTION$ 2500 EBLIA $ 2,000,000
<br /> ORKERS COMPENSATION �/ _
<br /> ND EMPLOYERS'LIABILITY YIN )(STATUTE ER
<br /> %NY PROPRIETORIPARTNERIEXECUTIVE $
<br /> D FFICERIMEMBER EXCLUDED? � NIA 9323099 09/I9/2024 08/19/2025 E.L.EACH ACCIDENT 1,000,000
<br /> Mandatary in
<br /> T yes,describe under
<br /> undnder E.L.DISEASE-EA EMPLOYEE 3 1,000,000
<br /> I
<br /> ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S I,000,000
<br /> Per Claim 2,000,000
<br /> A Professional Liability PSNO140087628 09/22/2024 09/22/2025 General Aggregate 2,000,000
<br /> Deductible S25,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required),
<br /> Additional Insured and Primary&Non Contributory:City of Santa Ana,officers,agents,employees,and
<br /> volunteers are named as additionally insured on this policy pursuant to Written contract,agreement,or
<br /> memorandum of understanding.Such insrtranec as is afforded b this policy shall be primary, """`•e"e11 i"'°"y p y p ry,and any insurance
<br /> carried b City shall be excess and noncontributory.y ty ry."30 Days notice Of Cancellation"'
<br /> CERTIFICATE HOLDER CANCELLATION
<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 risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> t1[.er�R�y}ell.
<br /> Santa Ana CA 92702
<br /> 1988-2015 ACORD CORPORATION. Ail rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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