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Item 15 - Renew Citywide Insurance Program and Policies Procured through Independent Cities Risk Management Authority and Arthur J. Gallagher
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08/05/2025
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Item 15 - Renew Citywide Insurance Program and Policies Procured through Independent Cities Risk Management Authority and Arthur J. Gallagher
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7/30/2025 4:59:33 PM
Creation date
7/30/2025 4:57:41 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Human Resources
Item #
15
Date
8/5/2025
Destruction Year
P
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City of Santa Ana /% CORE 360' <br /> err <br /> nI e "t <br /> I iu�ii�Upllll�llJlgUU�J�JN�'i��6ilq�1V�»;N'�ii� �JJ��UUU uuuJ� ���J�"aN1�i�ip �� �y�ii�U!ullll)111ViiJl�Ujl N���"N���In�ll11f�1�'I�NNNN�1'/���f��UI��JIk <br /> Subject To: <br /> D-1 (Effective January 1, 2020) <br /> Excess Liability Buffer-$1 M xs Signed TRIA Form. <br /> $2M SIR <br /> General Star Indemnity Company Confirmation of Binding Coverage must be signed at Binding <br /> Copy of signed E&S due diligence affidavit from retail agent must accompany any <br /> request to bind coverage. <br /> Subject To: <br /> Excess Liability Buffer-$1 M xs <br /> D-1 (Effective January 1, 2020) <br /> $21VI SIR Signed TRIA Form <br /> Princeton Excess&Surplus Lines <br /> Ins Co . Prior to binding, the Insurer requires a completed, signed, and dated UM/UIM <br /> acceptance/rejection form. <br /> Confirmation of Binding Coverage must be signed at Binding <br /> Excess Workers'Compensation <br /> Response Indemnity Company of N/A <br /> California <br /> DIC-$51VI Part of$10M Signed Terrorism Disclosure Form prior to binding <br /> Endurance American Specialty Ins <br /> Co D-1 (Effective January 1, 2020) <br /> Subject to - requested information is received within 30 days, automatic NOC must be <br /> sent contingent upon receipt of information <br /> DIC-$2.51VI Part of$10M D-1 (Effective January 1, 2020) <br /> Palms Insurance Company, Limited Signed TRIA Disclosure Notice(s)(required at binding) <br /> The complete Named Insured listing (if any)is per schedule on file with the Program <br /> Manager <br /> DIC-$2.51VI Part of$10M <br /> Landmark American Insurance D-1 (Effective January 1, 2020) <br /> Company <br /> Subject to <br /> D-1 (Effective January 1, 2020) <br /> Excess DIC-$51VI xs$10M Please include up-to-date additional interest information such as Additional Named <br /> Mt Hawley Insurance Company Insureds,Additional Insureds, Mortgagees and Loss Payees with the bind request, if <br /> Lloyd's Synd 1458(RenaissanceRe applicable. <br /> Synd) <br /> Conditional binding subject to receipt and review of primary binder within 5 days.Any <br /> changes or discrepancies may invalidate this binder <br /> Subject to receipt of the primary policy within 45 days of binding. <br /> Excess DIC-$10M Excess $15M Subject to <br /> Palomar Excess and Surplus D-1 (Effective January 1, 2020) <br /> Insurance Company <br /> Princeton Excess&Surplus Lines Signed Insurance Applications and Acknowledgement of State Fraud Warnings. <br /> Ins Co Notice Regarding Surplus Lines Filing Confirmation and TRIPRA Rejection Forms <br /> 51 <br /> ���44 CDllllllll IIIIIIIJIIIIIIIIiiI�1J1111�1 i�,� <br /> . .....,,,,,,, ..«< <br />
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