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DATE(MM/DDIYYYY)
<br /> .a►co�ra� CERTIFICATE OF LIABILITY INSURANCE
<br /> 101OV2U25
<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. N
<br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed,If
<br /> SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this
<br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME:
<br /> Aor, Risk Insurance Services West, Inc. PHONE (g66) 283-712Z FAX (8QD) 363-0105
<br /> Los Angeles CA Office (AIC.No.EXt): W'c.No.: CD
<br /> CD
<br /> 707 Wilshire Boulevard E-MAIL
<br /> suite 2600 ADDRESS: _
<br /> Los Angeles CA 90017-0460 USA INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSUHED INSURER A. safety National Casualty Corp 15105
<br /> Tetra Tech, Inc. INSURER B: Allied world Surplus Lines Insurance Co 24319
<br /> 17895 Von Karman Ave., Suite 500
<br /> Irvine CA 92614 USA ASURERC: American International Group UK Ltd AA1120187
<br /> INSURER D!
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 570115917585 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.NCTWITHSTANDING 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. Limits shown are as requested
<br /> NISH R. TYPE OF INSURANCE INSU WVU POLICY NUMBER MM!DDlYYYY Ml lDD1YYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y GL 7 4 EACH OCCURRENCE $1,000,000
<br /> C LAOCCURDAMAGE TO
<br /> W n=
<br /> ::1 PREMIS ES Ea occu rren �ce 1,000,0OD
<br /> X X,C,U Coverage MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000 m
<br /> GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE
<br /> X I $1,000,000 n
<br /> POLICY I PRC LOC PRODUCTS-COMP/OP AGG s1,000,000 rQ'n
<br /> 1 JECT
<br /> OTHER: o
<br /> r
<br /> A AUTOMOBILE LIABILITY Y Y CA 6676805 10/01/2025 10/01/2026 COMBINED SINGLE LIMIT
<br /> Ea accident S1,000,000
<br /> X Al BODILY INJURY(Per person) Z
<br /> OWNED SCHLUJLE❑ BODILY INJURY(Per accident) W
<br /> AUTOS ONLY AUTOS
<br /> HIRED AUTOS NON OWNED PROPERTY DAMAGE ti
<br /> - ONLY AUTOS ONLY Per accident -
<br /> m
<br /> C X UMBRELLA LIAB H OCCUR 62785232 10/01/2025 10/01/2026 EACH OCCURRENCE $5,000,000 U
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,D00
<br /> DED I RETENTION
<br /> A WORKERS COMPENSATION AND Y LDC4068970 10/O1/2025 10/DI/2026 x PER STATUTE I JOTH-
<br /> EMPLOYERS'LIABILITY YIN AOS ER
<br /> A ANY PROPRIETOR?PARTNER rFXECUTIVE p54068969 10 O1 2 E.L.EACH ACCIDENT $1,000,000
<br /> OFFICEWMEMBER EXCLUDED? NIA / / 02 5 10/01/2026
<br /> (Mandatory in NH) WI E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes.describe under
<br /> ❑ESCRIPTION OF OPERATIONS below El.DISEASE-POLICY LIMIT $1,000,000—_
<br /> B Environmental contractors and 103120276 10/01/2025 10/01/2026 Each Claim $2,000.000
<br /> Prof Prof/Poll-Claims Made Cov Aggregate S2,000,000
<br /> SIR applies per policy terns & condi ions r?�
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: job Description: on-Call Engineering Design Services for PEAS Treatment Systems, I No. 22-133, Agreement NO. tr
<br /> A-2023-053-01. Stop Gap coverage for the following states: OH, ND, WA WY. City of Santa Ana, its City council, officers,
<br /> officials, employees, agents and volunteers are included as Additional Insured in accordance with the policy provisions of the
<br /> General Liability and Automobile Liability policies as required by written contract. General Liability and Automobile Liability
<br /> policies evidenced herein are Primary and Nor-Contributory to other insurance available to an Additional Insured, but only in
<br /> accordance with the policy provisions as required by written contract. A waiver of subrogation is granted in favor of City of
<br /> Santa Ana, its City Council, officers, officials, employees, agents and volunteers in accordance with the policy provisions of
<br /> CERTIFICATE HOLDER APPROVED CANCELLATIONIll
<br /> By Tu Tran Nguyen at 2:25 pm,Oct Of,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br /> POLICY PROVISIONS.
<br /> City Of Santa Ana AUTHOHIZED REPRESENTAT€VE
<br /> Attn: Heidi Chou I7Igilzlly signe
<br /> San S. Center St., M-85 Tt�Tran Nguyen
<br /> Santa Ana CA 92701 USA Ngnyen
<br /> Nguyen +'�Uen Date-�2025,10. 1 Ma rift 71G
<br /> 77 14:2637-DT0 -
<br /> @1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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