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CSGCONS-01 JPERRY3
<br /> ACOROI` ATE(MMIDDIYYYY)
<br /> P
<br /> CERTIFICATE OF LIABILITY INSURANCE 121612024
<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#OC36861 CONTACT Julia Perry
<br /> Alliant Insurance Services,Inc. PHONE FAX
<br /> 560 Mission St 6th FI AIC,Na,Ext):(925)280-4671 (A/C,No):
<br /> San Francisco,CA 94105 A oRIL s:Julia.Perry@alliant.com
<br /> INSURER 5 AFFORDING COVERAGE NAIC If
<br /> INSURER A:United States Fire Insurance Company
<br /> INSURED INSURER B:Nationwide Affinity Insurance Company of America 26093
<br /> CSG Consultants,Inc. INSURER C:North River Insurance Company 21105
<br /> 550 Pilgrim Drive INSURER D:United States Fire Insurance Company 21113
<br /> Foster City,CA 94404 INSURER E:Pacific Insurance Company, Limited 10046
<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 /> ILTR NSR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR X 5432352732 12/412024 12/412025 pREIAGES Ea.Nc ED ce $ 300,000
<br /> MED EXP(Any one erson $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000
<br /> I HPOLICY�JE CT PRO- Fx-1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER:
<br /> $
<br /> B AUTOMOBILE LIABILITY COAEaaBINEDSINGLE LIMIT ccident) $ 1,000,000
<br /> X ANY AUTO X 72APB010186 121412024 121412025 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> EXCESS LIAB CLAIMS-MADE 5821248132 12/4/2024 12/412025 AGGREGATE $ 5,000,000
<br /> DEO I X I RETENTION$ 10,000
<br /> D WORKERS COMPENSATION �( PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN T E
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE 4087479726 1214I2024 12/4/2025 1,000,000
<br /> E.L.EACH ACCIDENT r
<br /> (Mandatory In ER EXCLUDED? N 1 A $ 1,000,000
<br /> (Mandatory in and E.L.DISEASE EA EMPLOYE
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> E Professional Liab 83 OH 0489503-24 12/4/2024 1214/2025 1 Ea ClaimlAgg 5,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required)
<br /> 30-day Notice of Cancellation applies to the Auto Liability policy,form to follow,
<br /> Re:Consultant Agreement for Municipal Plan Check Services City of Santa Ana,officers,agents,employees,and volunteers are named as additionally
<br /> insured on this policy pursuant to written contract,agreement,or memorandum of Understanding.Such insurance as is afforded by this policy shall be
<br /> primary,and any insurance carried by City shall be excess and noncontributory per general liability and automobile liability per attached endorsements. 30
<br /> Day Notice of Cancellation on Professional Liability per attached.
<br /> APPROVED_
<br /> CERTIFICATE HOLDER CANCELLATION By Cynthia Mora at 8:50 am, Dec 13, 2024
<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 /> Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza,4th Floor
<br /> Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016103) OO 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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