|
ACC CERTIFICATE OF LIABILITY INSURANCE 13ATE(MMa7DrrYyYI
<br /> 05/06/2025
<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(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 C
<br /> ONTACT Daniel Benson
<br /> AssuredPartners Northeast,LLC. NE (914)761-9000 F
<br /> No t: A1C,No: (914)761-3749
<br /> 445 Hamilton Avenue Daniel.Benson assured artners.comkith Floor � pGCOVERAGE NAIC X
<br /> White Plains NY 10601 URERA: Travelers Indemnity Company of Connecticut 256$2
<br /> INSURED INSURER B: Travelers Property Casualty Company of Arne nca 25674
<br /> Pacific Traffic Control,LLC INSURER C: Admiral insurance Company 24856
<br /> 2840 Lugo Street INSURER D:
<br /> INSURER e:
<br /> Las Angeles CA 90023
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: CL2541445612 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 /> 1N513 POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVO POLICY NUMBER MMIDDIYYYY (MM1ODPfYYY) LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY 11000,000
<br /> ENCE g
<br /> CLAIMS-A.IADE OCCUR EACH OCCURRPREMISES Ea accurrence S 300,000
<br /> MEO EXP(Arty one person) $ 5.000
<br /> A Y Y Y-630-5Y374343-TCT-25 04114/2025 04/14/2026 1 000 000
<br /> PERSONAL£ADV INJURY $
<br /> GEN'L AGGREGATE LIMITAPPLIESPER: GENERAL AGGREGATE g 2,000,00()
<br /> POLICY
<br /> JEPROtrT r7 LOC
<br /> PRODUCTS-CDMPfOPAGG g 2,000,000
<br /> OTHER: S
<br /> AUTOMOBILE LIABILITY COM31NED SINGLE LIMIT
<br /> ANYAUTO Ea accident S 1,000,000
<br /> BODILY INJURY(Per personl S
<br /> A OWNED SCHEDULED Y Y BA-5Y317895-25-14-G 04/14/2025 0411412026 BODILY INJURY(Per accident) $
<br /> HIRED AUTOSNON-OWNEDPROPERTY DAMAGE AUTOS ONLY At1T05 ONLYLY Per accident $
<br /> Auros ONLY Auros
<br /> $
<br /> UMBRELLALIAB X OCCUR 5,000,000
<br /> EACH OCCURRENCE 5
<br /> B EXCESS Lraa CLA:14ts-MADE CUP-9X37058$-25-14 04/14/2025 04/14/2028 AGGREGATE g 5,000,000
<br /> DEC RETENTION g
<br /> WORKERS COMPENSATION S
<br /> PER OTH.
<br /> AND EMPLOYERS'LIABILITY Y!N STATUTE ER
<br /> ANY PROPRIETOPJPARTNEFUEXECUTIVE
<br /> OFFICERW MBEREXCLUDED? ❑ N!A N/A E.L.EACH ACCIDENT g.
<br /> (Mandatory in NH)
<br /> If yes,describe under E.L.DISEASE-EA Eh1PLOYEE S
<br /> DESCRIPTION OF OPERATIONS below
<br /> E.L.DISEASE-POLiCYLIMIT S
<br /> Commercial Cyber and E&O Liability General Aggregate $1,000.000
<br /> C E000002533-12 04114t2025 04114,'2026 Each Occurrence $1,000,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES IACORD 141,Additional Remarks Schedule,may be attached it more space is required)
<br /> The City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as Additional Insureds.Additional Insured status is
<br /> granted with respects to General Liability on a Primary&Non-Contributory basis,when required by written contract,per farm CGD269 04116(copy
<br /> attached),Additional insured status is granted for Auto Liability,per form CAT353 02115(copy attached).
<br /> Waiver of Subrogation applies to General Liability and Auto Liability, Tr
<br /> an I 1 n Digitally signed by APPROVED
<br /> 7u Tran Nguyen
<br /> Date-2025.0s.12 ey To Tram Ngul yen at 7:21 aril,May 12.2025
<br /> Nguyen 07,22:27-a7GG _--
<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 Attention:Parks,Recreation,and Community Service ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza,
<br /> CA 92701.M-23 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701 y� 1
<br /> a0 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|