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AC—C)R EP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br /> 9130/2024
<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 polieles may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsernent(s).
<br /> PRODUCER CONTACT
<br /> Graham Company, NAME: James H. Bonner
<br /> PHONE
<br /> a Marsh& McLennan Agency, LLC company eN Elio: 215-567-6300 No):215-525-0234
<br /> One Penn S uare West E-MAIL
<br /> � ADDRESS: BONNER—UNIT@grahamea.com
<br /> Philadelphia PA 19102 NSU RSC1 FORDIQNG VERA E �NjAICi1
<br /> a All
<br /> INSURER 1: I r1c @f O. Angie ce V 16404
<br /> INSURED
<br /> Corporation o D 1 INsuREr46:1' ' s ° t 125674
<br /> 305 Commerce Drive INSURERC: LLLM Insurance Corporation 33600
<br /> Moorestown, NJ 08057 INSURERD:
<br /> INSURER E:
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER:724652814 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 ADDL SUBR
<br /> LTR TYPE OF INSURANCE POLICY NUMBER MMIDDYIYYYY MM!�fY EFF EY�YY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y TB7-Z51-290099-074 101112024 1011/2025 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE �OCCUR DA
<br /> PREMSES©aoocumence $700,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'LAGGRE�GATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY� PRO-
<br /> POLICY El LOC PRODUCTS-COMPIOPAGG $2,000,000
<br /> OTHER:
<br /> C AUTO MOBILELIABILITY Y I AS5-Z51-290099-034 10/1/2024 10/1/2025 COMBINED SINGLELIMIT $1,000,D00
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-DINNED
<br /> AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $
<br /> X Per accident
<br /> Phys Dmg PD Deductible $1,000
<br /> A X UMBRELLA LIAB X OCCUR TH7-Z51-290099-084 10/112/24 101112025 EACH OCCURRENCE 3 10,000,00fl
<br /> EXCESS LIAR CLAIM&MADE
<br /> AGGREGATE $10.000,000
<br /> DED RETENTION
<br /> C WORKERS COMPENSATION Y WC5-Z51-290099-014 101112024 10fti2025 PER
<br /> X $
<br /> -
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE EROTH
<br /> i ANYPROPRIETORIPARTNERIEXECUTIVE
<br /> 0FFICERIMEMBEREXCLUDED? NIA E.L.EACH ACCIDENT $1,000,600
<br /> Mandatory in
<br /> under EE
<br /> If yes,describe under E.L.DISEASE-FA EMPLOY $1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Professional Liability ZPL-61N57784-24-13 1 101112024 1011/2025 Per ClaimlAgg. $5,000,000
<br /> fi
<br /> I
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required)
<br /> City of Santa Ana, officers,agents,employees, and volunteers are Additional Insureds on a primary and non-contributory basis on the above General Liability
<br /> and Auto Liability policies if required by written contract.
<br /> Prior to loss, and if required by written contract, a Waiver of Subrogation is provided in favor of the Additional Insureds on the above General Liability and
<br /> Workers Compensation policies for work performed under Contract if permissible by state law,
<br /> 30 Days Advance Written Notice of Cancellation(10 Days for Non-Payment of Premium)is provided to the Certificate Holder.
<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 PRC
<br /> Risk Management Division 4�„.R<H�¢ xl3kkTvlanWm"aDt�Ia(an
<br /> 20 Civic Center Plaza A )10RIZED.,PE PRESENTATIVE a:' 'y REVIEWED&APPROVE BY.
<br /> Santa Ana CA 92702 '
<br /> Risk Management Specialist
<br /> c0 1988-2015 ACORD
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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