AC Roy CERTIFICATE OF LIABILITY INSURANCE 7E(MM/DDIYYYY)
<br /> /22/2025
<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 poiicypes)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 endorsoment(s).
<br /> PRODUCER CONTACT
<br /> Aon Private Risk Mgmt - Phoenix NAME: Doreen AdelmanPHONE
<br /> FAX
<br /> 2555 E Camelback Rd c o Ext: (951) 772-8720 fAIC.
<br /> No:
<br /> E-MAIL
<br /> Phoenix AZ 85016 ADDRESS: doreen.adelman@aon.com
<br /> INSURERS AFFORDING COVERAGE NAIC 4
<br /> INSURERA:Travelers Property Casualty Co 25674
<br /> INSURED INSURERS:Travelers Property Casualty CD 25674
<br /> Robert D. Niehaus, Inc
<br /> INSURERC: Ina Co of the State of PA/AIG 19429
<br /> 140 E. Carrillo Street INSURER ID:Houston Casualty Company 42374
<br /> Santa Barbara CA 93101 INSURER E:UNDERWRITERS AT LLOYD IS, LONDON 115792
<br /> INSURERF: Continental Casualty Co 1 20443
<br /> COVERAGES DA CERTIFICATE NUMBER:Cart ID 49754 (72) 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 /> ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM1DDfYYYY POLICY
<br /> LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> DAMA E TO RENTED
<br /> CLAIMS-MADE X OCCUR Y Y 680-OX748952-24-42 09/01/2024 09/01/2025 PREMISES Eaoccurronce $ 300,000
<br /> MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> X POLICY PEd LOG PRODUCTS-COMP/OP AGG $ 4,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
<br /> Ea accident 1,000,000
<br /> A ANYAIJTO Y Y 680-OX748952-24-42 09/01/2024 09/01/2025 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROFERTYDAMAGE
<br /> X AUTOS ONLY X AUTOS ONLY Per accident $
<br /> A UMBRELL41-IA6 X OCCUR Y Y CUP-OX751286-24-42 09/01/2024 09/01/2025 EACH OCCURRENCE $ 5,000,000
<br /> X EXCESS LIAR CLAIMS-MADE gGGREGATE $ 5,000,000
<br /> DED RETENTION$ $
<br /> B AND WORKERS ION
<br /> YIN Y UB-OX750517-24--42-G 09/01/2024 09/01/2025 X STATUTE PPRH
<br /> AND EMPLOYERS'LIApILITY
<br /> ANYPROPRIEToMPARTNERIEXECUTIVE ❑ F.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICEWMEMBEREXCLUDED? N 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 /> F EPLI 6052145186 09/01/2024 09/01/202SEPLI Aggregate Limit $ 1,000,000
<br /> A Property - Commercial 680-OX748952-24-42 09/01/2024 09/01/2025 Blanket Bus Per $ 831 798
<br /> Pro - Dad $1 000 '
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more apace Is required)
<br /> Executive Director Public works Agency, City of Santa Ana and, it's Officers, Officials, Employees,
<br /> and
<br /> Insuredixperewrittentcontracteondfile. includes Blankets Waiverso£oSubrogationaandnBlanketePrimarry TU Tran,TTra„Ngyedb
<br /> Wording endorsement. Cancellation is 30 days except for non-payment which is 10 days. Excess .83223-D?'0A4
<br /> follows the General Liability, Auto and Work Comp. NgUyelloasz2a-oroa
<br /> APPROVED
<br /> By Tu-Fran Nguyen of-8:32 am_J1Ih1 Qo02.6-
<br /> CERTIFICATE HOLDER 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 PROVISIONS.
<br /> Attn: Water Resources Division (M-85)
<br /> 220 S. Daisy Avenue, Bldg A AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92703 �k4fd+PCjMtf.�NE.
<br /> 31988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|