|
LYONSEC-01 EDURHAM
<br /> ,q►c[�Rn CERTIFICATE OF LIABILITY INSURANCE DAT1132D/YYYY)
<br /> 113I2025
<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 License#0757776 CONTACT Lisa Glynn
<br /> HUB International Insurance Services Inc. PHONE FAx
<br /> 548 W Cromwell Avenue (A/C,No,E%4 (AC,No):
<br /> Suite 101 E-MAIL ss:lisa.glynn@hubinternational.com
<br /> Fresno,CA 93711 ,
<br /> INSURERS AFFORDING COVERAGE MAC#
<br /> INSURER A:Starstone Specialtv Insurance Company 44776
<br /> INSURED INSURER B:Arch Insurance Company 11150
<br /> Lyons Security Service,Inc INSURER C
<br /> 505 S.Villa Real Dr.Suite 203 A INSURER D
<br /> Anaheim,CA 92806
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE � OCCUR X X WSGL002518 11112025 1/112026 PAREM 1ISEETOEa ENcu°ne® $ 100,000
<br /> MED EXP(Any one erson $ 5,000
<br /> PERSONAL BADVINJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ 5,000,000
<br /> POLCY�I JE� Fx] LOG PRODUCTS-COMPIOPAGG $ 5,000,000
<br /> OTHER, ERRORS AND OMIS $ 1,000,000
<br /> AUTOMOBILE COMBINEOtSINGLELIMIT 1,000,000
<br /> Ea aeciden $
<br /> X ANY AUTO X X ZACAT1206701 111/2025 11112026 BODILY INJURY Per erson S
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> HIRED NON-PINNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> $
<br /> A UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> X EXCESS LAB CLAIMS-MADE WSGUO00630 1/112025 11112026 AGGREGATE $ 5,000,000
<br /> DED X I RETENTION$ 10,000
<br /> B WORKERS COMPENSATION X STAT TE 11RH
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRI ETC RIPARTNERIEXEC UTIVE YIN X 2AWC19792801 11112025 1I112026 1,000,000
<br /> E.L.EACH ACCIDENT $
<br /> CFFfCERlMEMBER EXCLUDED? N J A
<br /> (Mandatary in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000
<br /> If yes.describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS behow ! E.L.DISEASE-POLICY LIMIT $
<br /> I
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORO 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Project Number:RFP 22-026
<br /> Additional Insured. The City of Santa Ana,its officers,employees,agents,volunteers and representatives
<br /> The above listed excess policies are following form and extends the GL occurrence limit to$6,000,000 and the aggregate limit to$10,000,000. GL waiver of
<br /> subrogation is included on attached form CG24040509.
<br /> Endorsements Attached:CG201000704,CIGL300114,CG24040509,00CA0070001013,CA04441013,WC040306
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANC By Cynthia Mora at 4:16 pm, Jan 13, 2025
<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 /> y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92702 AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|