Laserfiche WebLink
AGENCY CUSTOMER ID: <br />LOC #: <br />AC R ® ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY <br />NAMED INSURED <br />GMGS Risk Management & Insurance Services <br />9 <br />EEC Environmental <br />dba: Environmental Engineering & Contracting, Inc. <br />One City Boulevard West, Suite 1800 <br />Orange CA 92868 <br />POLICY NUMBER <br />CARRIER <br />NAIC CODE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (03/16) <br />HOLDER: City of Santa Ana Attention: Public Works Agency <br />ADDRESS: 20 Civic Center Plaza (M-21) Santa Ana CA 92701 <br />All operations of the named insured subject to the terms and conditions of the policies. <br />As respects General Liability coverage, City of Santa Ana, its City Council, officers, <br />officials, employees, agents, and volunteers are added as Additional Insureds per <br />CG20261219 attached, and this insurance is primary per CG20011219 attached. <br />As respects General Liability coverage, a Waiver of Subrogation is hereby included per <br />CG24040509 attached. <br />As respects General Liability coverage, 30-day written notice of cancellation (10 days for <br />non-payment of premium) applies per IL00171198 attached. <br />As respects Automobile Liability coverage, City of Santa Ana, its City Council, officers, <br />officials, employees, agents, and volunteers are added as Additional Insured per <br />BENVCA060917 attached. <br />As respects Automobile Liability coverage, a Waiver of Subrogation is hereby included per <br />CA04441013 attached. <br />As respects Workers' Compensation coverage, a Waiver of Subrogation is hereby included per <br />WC990634 attached. <br />As respects Workers' Compensation coverage, 30-day written notice of cancellation (10 days <br />for non-payment of premium) applies per WC040601A attached. <br />As respects Professional Liability coverage, City of Santa Ana, its City Council, <br />officers, officials, employees, agents, and volunteers are added as Additional Insureds <br />per CCP30050318 attached. <br />As respects Professional Liability coverage, a Waiver of Subrogation is hereby included, <br />per ENV20040618 attached. <br />ACORD 101 12008/011 © 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD ADDENDUM <br />94413046 1 24-25 A/U/U/W/P011/R&0 I exc1:XS I Deni Rembleeki 13/16/2025 11:45:14 AM (PDT) I Page 2 of 14 <br />