Laserfiche WebLink
ACOROF CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MWDD/YYYY) <br />3/13/2025 <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(tes) 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 endarsement(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 FAX <br />N 818-598-8900 A c No), 818-598-8910 <br />pones <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURER A: Continental Insurance Company A XV <br />35289 <br />www.venbrook.com CA LID No. OD80832 <br />INSURED <br />Cannon Corporation <br />1050 Southwood Drive <br />INSURER B: Hartford Casualty Insurance Company A+XV <br />29424 <br />INSURER C: Beazley Insurance Company, Inc. A XV <br />37540 <br />INSURERD: <br />San Luis Obispo CA 93401 <br />INSURER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 84347833 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 <br />LTR <br />rypE OFINSURANCE <br />ADOL <br />SUER <br />POLICYNUMBER <br />POLICY EFF <br />MMMD/YYYY) <br />POLICY EXP <br />fMMMDNYYYI <br />LIMITS <br />COMMERCIALGENERAL LIABILITY <br />CLAIMS -MADE �✓ OCCUR <br />✓ <br />�/ <br />7039996776 <br />9/1/2024 <br />9/1/2025 <br />EACH OCCURRENCE <br />$1000000 <br />ERENTED <br />PREMISES <br />PREMISESS(Ea occurrence <br />$100 000 <br />✓ <br />MED EXP (Any one person) <br />$15 000 <br />Contractual Liability <br />PERSONAL& ADV INJURY <br />$1 000 OOO <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY Z J'ERO LOC <br />GENERAL AGGREGATE <br />$2,000,000 <br />PRODUCTS- COMP/OP AGO <br />$ 2 000 000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />✓ <br />✓ <br />BUA 7040001609 <br />9/1/2024 <br />9/1/2025 <br />EOa so accident) SINGLE LIMIT <br />$1 000 000 <br />✓ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOSOND AUTOS <br />BODILY INJURY P <br />(Per accident) ) <br />$ <br />✓ <br />WNED <br />AUTOS ONLY HIRED kV AUTOS ONLY <br />P pE.R,l nDAMAGE <br />$ <br />$ <br />Com /Coll Deble $1,000 <br />A <br />✓ <br />UMBRELLA LIAB <br />,� OCCUR <br />CUE 7040002176 <br />9/1/2024 <br />9/1/2025 <br />EACH OCCURRENCE <br />$9000000 <br />AGGREGATE <br />$ 9 OOO O00 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED ✓ RETENTION$ 10,000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/N <br />ANYPROPRIETOR/PARTNERIEXECUTIVE <br />OFFICER/MEMBEREXCLUDEDI <br />N/A <br />✓ <br />72 WE OL6HIH <br />9/1/2024 <br />9/1/2025 <br />,i STATUTE ERH <br />E.L. EACH ACCIDENT <br />$1 GOO 000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1 ,000,000 <br />(Mandatory in NH) <br />Ii yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1000000 <br />C <br />Professional/Pollution Liability <br />✓ <br />✓ <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/l/2024 <br />9/1/2025 <br />$125,000 Limit; $1,000 Deductible <br />A <br />Contractors E ui merit -Scheduled <br />7039996776 <br />9/l/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 mare space is required) <br />RE: On -Call Water Resources Engineering Services City of Santa Ana RFP No. 24-083 Carillon Project Number 240714 <br />**SEE ATTATCHED ADDENDUM'** <br />Tu Tran Digitally signed by <br />Tu TanDater 20Nguy25.03ei] APPROVED <br />Nguyen 15,54:47-07-00• Bit Tu Tran NaUVen at 3:53 Dm. Mar 17. 2025 <br />City of Santa Ana <br />Attention: Public Works A ency <br />20 Civic Center Plaza (M$1) <br />Santa Ana CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ACORD 25 (2016/03) <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />84347633 1 24-25 GL/AL/WC/UM/PL I Isabella Saldivai 1 3/13/2025 11:5n:56 AM (PDT) I Page 1 of 15 <br />