|
76/23/2025
<br /> E(MM/DDYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE /Y
<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 /> Risk Strategies Company PHONE NAMESherr Young
<br /> FAX
<br /> 2040 Main Street, Suite 450 A/c No Ext: 949-242-9237 A/c No):
<br /> Irvine, CA 92614 ADDRESS: syoung@risk-strategies.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> www.risk-strategies.com CA DOI License No.OF06675 INSURERA: Hartford Underwriters Insurance Company 30104
<br /> INSURED INSURERB: Hartford Casualty Insurance Company 29424
<br /> BPR Consulting Group INSURERC: Arch Insurance Company 11150
<br /> P.O. Box 2404
<br /> Granite Bay CA 95746 INSURERD: At-Bay Specialty Insurance Company 19607
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 85892755 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 LIMITS
<br /> LTR INSD WVD POLICYNUMBER MM/DD MM/DD
<br /> A / COMMERCIAL GENERAL LIABILITY / / 72SBABM3ZJ9 7/1/2025 7/1/2026 EACH OCCURRENCE $2,000,000
<br /> Am
<br /> CLAIMS-MADE Iv] OCCUR PREM SESOEa occurrrence $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $4,000,000
<br /> POLICY ✓� ECT LOC PRODUCTS-COMP/OPAGG $4,000,000
<br /> 1� PRO-
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY 72SBABM3ZJ9 7/1/2025 7/1/2026 (CEO,acccidentSINGLE LIMIT $2,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident
<br /> A / UMBRELLA LAB / OCCUR 72SBABM3ZJ9 7/1/2025 7/1/2026 EACH OCCURRENCE $1,000,000
<br /> EXCESS LAB CLAIMS-MADE AGGREGATE $1,000,000
<br /> DED ✓ RETENTION$10,000 $
<br /> B WORKERS COMPENSATION ✓ 72WECAS9HLT 7/1/2025 7/1/2026 �/ STATUTE EERH
<br /> AND EMPLOYERS'LIABILITY Y/N
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑ N/A
<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 /> C Professional Liability ✓ PAAEP0168601 7/1/2025 7/1/2026 Per Claim:$2,000,000
<br /> Aggregate:$4,000,000
<br /> D C ber Liability AB-6658419-03 10/14/2024 10/14/2025 LI:$3,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Projects as on file with the insured.
<br /> The City of Santa Ana, its officers,officials,employees,and volunteers are named as additional insureds and primary/non-contributory clause
<br /> applies to the general liability policy and a waiver of subrogation applies to the general liability,work comp and professional liability policies.
<br /> signed
<br /> Tu Iran TuTralnyNguyenby
<br /> Date:2025.06.25 APPROVED
<br /> Nguyen 07:29:06-07'00'
<br /> By Tu Tran Nguyen at 7:28 am,Jun 25,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> Planning and Building Agency ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE
<br /> RSC Insurance Brokerage
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br /> 85892755 125-26 GL-HNOA-UL-WC-PL, 24-25 CYBER Sherry Young 16/23/2025 3:07:46 PM (PDT) I Page 1 of 9
<br />
|