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E(MMIDDi F
<br /> A6C)R" CERTIFICATE OF LIABILITY INSURANCE DAT711alzoza
<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 CONTACT
<br /> NAME: Stefanie Fuller
<br /> ASSUredPartners Design Professionals Insurance Services, LLC PHONE FAx
<br /> 3697 Mt. Diablo Blvd., Suite 230 rc No,Exit: -. Arc No):
<br /> Lafayette CA 94549 ADDRESS:
<br /> N of c#
<br /> License#,6003745 INSURERA: ran o I s Company 20494
<br /> INSURED INSURER B Yi9MYCompany 37885
<br /> WARE MALCOMB T
<br /> 10 Edelman INSURER{: COr t I sur G a 9
<br /> Irvine CA 92618 wsUREF D: N°a;i .,A 8
<br /> Acevedo INSUP_R E I {
<br /> AF jRER F
<br /> COVERAGES CERTIFICATE NUMBER:1973768583 _ 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 TYPE OF INSURANCE ADDL SUBR - POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MMJDONYYY) (MM/DDfYYYYJ LIMITS
<br /> D X COMMERCIALGEN£RALLIABILITY Y Y 7015145376 6/20/2024 6/20/2025 EACH OCCURRENCE 51,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE OCCUR =1G3E5 Ea Occurrence 51,000,000
<br /> MED EXP(Anyone person) $15,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000
<br /> POLICY" PRO- LOC PRODUCTS_-COMPIOP AGG $2,000,000
<br /> OTHER,
<br /> A AUTOMOBILE LIABILITY Y Y 7015145362 6120/2024 6120/2025 COMBINED SINGLE LIMIT S 1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) S
<br /> OWNED SCHEDULED
<br /> AUTOS ONL AUTOS BODILY INJURY(Per accident) S
<br /> Y
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE S
<br /> AUTOS ONLY AUTOS ONLY IPee accident
<br /> S
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $
<br /> DIED RETENTION$ $
<br /> C WORKERS COMPENSATION Y 7015145393 6/20/2024 6/20/2025 X PEAruTE ERH
<br /> C AND EMPLOYERS'LIABILITY Y 1 N 7015145409 612012024 6/20/2025
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1.000.000
<br /> OFFICERlMEMBEREXCLUDED? FE
<br /> NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000.000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Professional Liability DPR5028278 612012024 6/20/2025 Per Claim $2,000,000
<br /> Claims Made Annual Aggregate $2,000.000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> Project Name: Interiors Architectural Design and Engineering Services!On-call space planning and architectural agreement(A-2020-230-10)--
<br /> City of Santa Ana its officers,employees,agents,volunteers and representatives as additional insured(s)are named as Additional Insured on General Liability
<br /> and Auto Liability,per policy forms,with respect to the operations of the Named Insured as required by written contract. General Liability is
<br /> Primary/Non-Contributory per policy form wording. Auto Liability is Primary per policy form warding.Insurance coverage includes waiver of subrogation per the
<br /> attached endorsement(s).SEVERABILITY OF INTERESTS Separation of Insureds-Except with respect to the Limits of Insurance,and any rights or duties
<br /> specifically assigned in this Coverage Part to the first Named Insured,this insurance applies: a.As if each Named Insured were the only Named Insured;and
<br /> b.Separately to each insured against whom claim is made or suit is brought.
<br /> CERTIFICATE HOLDER CANCELLATION 34 Day Notice of 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 ACCORDANCE WITH THE POLICY PRC
<br /> Public Works Agency er Riak>N"%""entDNisilm
<br /> 20 Civic Center Plaza M-11 AUTHORIZED REPRESENTATIVE 3;, REv1EWED&APPROVED BY.
<br /> Santa Ana CA 92701 '!®'= A ka,44
<br /> Risk Management Speci.illist
<br /> ©1988-2015 ACORD
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br /> THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE
<br />
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