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C R CERTIFICATE OF LIABILITY INSURANCE QA7E2EMYY1}fl
<br /> 2/13/13/2025
<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(les)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 rl hts to the certificate holder In Ileu of such endorsements
<br /> PRODUCER Phone: (707)996-2912 CNAMNTEA01 lerilee Carpenter
<br /> Fax: (707)996.7912
<br /> Apollo General Insurance Agency,Inc.(1) PHONE F No):
<br /> P.0.Box 1508 ADDREAIL SS: jenleceapgan.eom
<br /> Sonoma,Califamia 95476 INSURERS AFFORDING COVERAGE NAIC0
<br /> INSURER A: Everest Indemnity Insurance Company 10851
<br /> INSURED INSURER a, Everest rational Insurance Company 10120
<br /> American Wrecking,Inc. INSURERC: State Compensation Insurance Fund OfCalifomia 35076
<br /> 2459 Lee Avenue INSURER 13, Tokio Marine Specialty Insurance Company 23850
<br /> South El Monte,CA 91733
<br /> ENSURER E
<br /> INSURERS:
<br /> COVERAGES CERTIFICATE NUMBER:1513 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 /> ILNS R TYPE OF INSURANCE AOOL SUER POLICY EFF POLICY EXP
<br /> POLICYNUMBER IMMIgorrml IMWDP= LIMITS
<br /> i/ COMMERCIAL 0 ENEFtAL LIABILITY Cr4GLO1371-241 4/2812024 4/28/2025 EACHOCCURRENCE $ 1,000,000
<br /> A IIAMA13E ToCLAIMS-MADE FI OCCUR PREMISES IEaEoccunence $ 300,000
<br /> I/ y MED EXP LPj?y oneperson) $ y
<br /> PERSONAL BADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: I GE14EMAGGREGATE $ 2,000,000
<br /> POLICY H JEC n LOC PRODUCTS-COMPIOPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILELIAeILITY CF4CA01390-241 9/1/2024 9/1/2025 Es eBBINEDISINGLE LIMIT $ 1,000,000
<br /> S
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accidan9 $
<br /> AUTOS ONLY AUTOS ✓ Y
<br /> I/ HIRED r/ NON OWNEO PROPERTY DAMAGE $
<br /> 1AUTOS ONLY AUTOS ONLY Par accidan
<br /> $
<br /> UMBRELLAUAB OCCUR XCSFX01605-241 4/28/2024 4/28/2025 FACH OCCURRENCE $ 5,000,000
<br /> A ✓ EXCESS LIAR rd CLAIMS-MADE AGGREGATE $ 5,004,000
<br /> DED I I RETENTION 5 S
<br /> C WORKERSCOMPENSATiON 9161690-24 10/1/2024 10/1/2025 / PESTATUTE ER
<br /> R OTH-
<br /> IN
<br /> AND EMPLOYERS'LIABILITY
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE Y,I"" E.L.EACH ACCIDENT S 1,000,000
<br /> OFFICERIMEMBEREXCLUDED7 u NIA 1 000 000
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 5 . ,
<br /> If yes devAbe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S
<br /> D Pollution liability PPK2657314-001 2/18/2025 2/18/2026 Per incident 51000,000
<br /> Ayprel;ata: 5,000,00
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addillonat Remarks Schedule,may be attached If more space Is required)
<br /> Re: Operations of the Names Insured. City of Santa Ana is hereby added as Additional Insured if required by written
<br /> contract per endorsement hereto, waiver of Subrogation is provided, as required by written contract with the insured
<br /> as respects coverage evidenced herein. Coverage evidenced herein is primary and non-contributory. Excess is follow
<br /> form to the underlying General Liability, Automobile Liability and Workers Compensation Coverage listed (schedule
<br /> attached). A 30--day written notice shall be mailed to the certificate holder at the address provided herein, should a
<br /> described policy(s) be cancelled before the expiration date thereof; 10-day notice for non-payment of premium.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> By Tu Tran Nguyen at 11:10 am,Mar 13, 2025
<br /> Holder's Nature of interest:Additional Insured
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92702 AUTHORIZEDREPRESEN;[1 E
<br /> fl��iN//I'JJ
<br /> ©1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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