|
^� MARKTHO-01 SEITAS
<br /> '4�oyr2o CERTIFICATE OF LIABILITY INSURANCE DAT192D�YYYY)
<br /> 9l1912025
<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, EXTENT? 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#OE67768 CONTACT Jessica McDonald
<br /> IOA Insurance Services PHONE FAX
<br /> 3875 Hopyard Road (AIC,No,Ext):(925)918 4535 JAM,No):
<br /> Suite 244 E-MAIL Jessica.McDonald ioausa.com
<br /> _A6DFE55: ,,.. .... ___,_,,,.
<br /> Pleasanton,CA 94588
<br /> .,. INSURER(Sy AI FORDING COVERAGE NAIC 9
<br /> -......................__-......._._.W INSURER A:Continental Casualty Company _ 20443
<br /> INSURED INSURER B:The Continental_Insurance Company 35289
<br /> Mark Thomas 8r Company,Inc. INSURER C:Valley Forge Insurance Compares 20508
<br /> 2833 Junction Avenue,Ste 110 1 INSURER D:
<br /> San Jose,CA 95134
<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 RLDUCED BY PAID CLAIMS.
<br /> INSR ADDL SUER POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE IN SD VIVID POLICY NUMBER D LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE ®OCCUR X X 7040185059 911512025 9/1512026 DAAMIAGETOERENTFD 1,000,000
<br /> SZC rrence ._
<br /> MED EXP LAny one arson 15,000
<br /> PERSONAL&ADV INJURY 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000
<br /> X POLICY❑JPEROT LOC PRODUCTS-COMP/OP AGG 2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY C0 'IN D{SINGLE LIMIT $ 11000,000
<br /> X ANYAUTO X X 7040183912 9/1512025 9/1512026 BODILY INJURY Per pqsonj. $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> HIRED NON-AWNED PROPERTY AMAGE
<br /> AUTOS ONLY AUTOS ONLY Per acci , $
<br /> B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 9,000,000
<br /> X EXCESS LIAB CLAIMS-MADE 7040283234 9/15/2025 9/15/2026 AGGREGATE $ 9,000,000
<br /> DED RETENTION$
<br /> C WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE €R
<br /> 7440274$25 911512025 9Ii 512026 E L EACH ACCIDENT $
<br /> ANY PROPRIETOFUPARTNERIEXEGUTiVE YIN
<br /> X 1,DOO,4DO
<br /> OFFICERIMEMBER EXCLUDED? N I A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE !$ 1,0D4,4DD
<br /> If yes,describe under 1,DDD,444
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Digitally signed
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required) Nguyen
<br /> 23-00056 NgUyen Dare:2025.10.08
<br /> 23-00056 is U:5s-a7'oo'
<br /> Re:Santa Ana-On-Call Engineering Services
<br /> City of Santa Ana,its officers,officials,employees and volunteers,named as additional insureds.
<br /> The Workers Compensation 1 Employers Liability Deductible is none. APPROVED
<br /> By Tu Trarr Nguyen at 2:19 pm, Oct 08,2025
<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 /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana
<br /> Attention:Public Works Agency, AUTHORIZED REPRESENTATIVE
<br /> CIP1Design Engineering
<br /> 20 Civic Center Plaza
<br /> lSanta 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 />
|