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VIDOSAM-01 F ADIAZ
<br /> CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY)
<br /> 8/11/211/2025
<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 endorsements).
<br /> PRODUCER �RMJACT
<br /> HUB International Insurance Services Inc. arc°,Mo,Et):(949 553-9800 FAX No):
<br /> 4695 MacArthur Court
<br /> Suite#600 U AIL
<br /> Newport Beach,CA 92660
<br /> INSURERS AFFORDING COVERAGE NAIC It
<br /> INSURER A:The Travelers Indemnity Company of Connecticut 25682
<br /> INSURED INSURER B:The Travelers Indemnity Company of America 25666
<br /> Vido Samarzich,Inc. INsuRER c:CorePointe Insurance Company 10499
<br /> 515 Cabrillo Park Dr.,Suite 315 INSURER D:Navigators Specialty In Company 36056
<br /> Santa Ana,CA 92701 INSURER E:Nautilus Insurance Company 17370
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1
<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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLIICDY EXP LIMITS
<br /> D POLICY NUMBER
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE [�]OCCUR X X 4T-CO-A7193762-TCT-25 11112025 1/1/2026 DA AGETORENTuDn $ 300,000
<br /> PREMMED EXP(Any one arson $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,400
<br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY LOC PRODUCTS-COMPIOPAGG $ 2,000,000
<br /> OTHER;
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00-
<br /> X ANYAUTO X X BA-A7193608-25-2S-G 11112025 11112026 BODILY INJURY Per erson $
<br /> AURRTOS ONLY AUTOSULEp BOORDILY INJURY Per accident $
<br /> RUTOS ONLY AU3NO ONLY Pe�accltlent AMAGE
<br /> B X UMBRELLA LIAR M
<br /> OCCUR EACH OCCURRENCE 5/0000000
<br /> EXCESS LIAB CLAIMS-MADE CUP-A7193842-25-2S 111/2025 1/1/2026 AGGREGATE 1 5,000,000
<br /> ❑E❑ X RETENTION$ 10,000
<br /> C WORKERS COMPENSATION X PER OTH-
<br /> ANDEMPLOYERS'LIABILITY YIN STATUE ER
<br /> CTP1003323 1/1/2025 111/2026 E.L.EACH ACCIDENT $
<br /> • ANY PROPRIETORlPARTNERlEXECUTIVE X 1,OOD,0O0
<br /> FICEWMEM EXCLUDED? NIA
<br /> and story In gER
<br /> NHl E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> IF yes describe under E,L.DISEASE-POLICY LIMIT
<br /> DESS RIPTION OF OPERATIONS below 110001000
<br /> D Umbrella Liability LA25EXCZ0K6PLIC 11112025 111/2026 Each Occ.lAgg. 3,000,000
<br /> E Pollution Liability CPL2047789-10 8/812025 818/2026 See Remarks
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 1p1,Additional Remarks Schedule,may be attached If more space is required)
<br /> RE:City of Santa Ana Project#25-6031;McFadden Avenue Transit Signal Priority Project, glaipwvfaualwvlwcwv
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as Additional Insureds as respects General Liability and
<br /> Auto Liability per attached endorsements.
<br /> This Insurance shall apply as Primary and Non-Contributory per attached endorsement.
<br /> Waiver of Subrogation for General Liability,Auto Liability and Workers'Compensation:See Attached Endorsements.
<br /> Tu Tran yfthy,qnedby
<br /> Tu T, Nguyen
<br /> Nguyen DA4s7-079 APPROVED
<br /> By Tu Tran Nguyen at 10.44 am,—Aug fa,-2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Public Works Agency ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> P.O.Box 1988 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana,CA 92702
<br /> ACORD 25(2016103) O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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