|
AC®RLI CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY)
<br /> 11111, .� 1 10/6/2025
<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 endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME:
<br /> Sequel Insurance Services, Inc. PHONE 27g_202-3979 FAX No:279-688-0001
<br /> 111 Scripps Drive
<br /> Sacramento CA 95825 ADDRESS: certificates se uelins,com
<br /> INSUl AFFORDING COVERAGE NA1C#
<br /> License#:6010509 INSURER A:Westchester Surplus Lines Insurance Company 10172
<br /> INSURED ECORCON-01 INSURER B:Travelers Property Casualty Com an of America 25674
<br /> Consulting, Inc.
<br /> 2525 Warren Dr INSURERC:StarStone National Insurance Company 25496
<br /> 2525 W
<br /> Rocklin CA 95677-2167 INSURER D:ACE Property&Casualty Insurance Company 20699
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:695603910 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 /> I�TR TYPE OF INSURANCE JI=Jii SUER POLICY NUMBER POLICY
<br /> M DOYmri v MMI��IYYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y G71832193 D06 1011/2025 10/1/2026 EACHOCCURRENCP $4,000,000
<br /> CLAIMS-MADE OCCUR {DAMAGE TO RENTED
<br /> PREMISES Ea occurrence $100,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $4,000,000
<br /> GEN'4AGGRFGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY X PE07 LOC PRODUCTS-COMPIOPAGG $4,000,000
<br /> OTHER: Deductible $10,000
<br /> D AUTOMOBILE LIABILITY Y Y H08475210 006 1D/112025 10/112026 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accideni
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED Per accident
<br /> AUTOS ONLY AUTOS ( }BODILY INJURY $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> IAUTOS ONLY AUTOS ONLY Per accident
<br /> Comp/CoI1 Deductible $1,000
<br /> B UMBRELLALIAB X OCCUR CUP-AO957690-25-NF 10/112025 10/1/2026 EACH OCCURRENCE $5,000,000
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $s,aao,aoo
<br /> ❑ED X RETENTION$ $
<br /> C WORKERS COMPENSATION Y T10251573 6/3I2025 6/312026 X TATUTE ERH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANYPROPRIFTORIPARTNERIEXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBEREXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISH.ASE-FA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Contractors Pollution Liability G71832193 006 1011/2025 10/1/2026 Each Pollution Cord. 4,000,000
<br /> Retro Date 10/112021 Aggregate 4,000,000
<br /> Deductible 10,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Professional Liability-Carrier:Westchester Surplus Lines Insurance Company-Policy#G718321 93 006-Effective 10/1/2025-10/1/2026-Each Claim Limit:
<br /> $4,000,000-General Aggregate Limit:$4,000,000-Retro Date 10/1/2021 -Deductible:$10,000
<br /> Third Party Crime-Carrier:Travelers Casualty and Surety Company of America-Policy#106602012-Effective: 1011/2025-101112026-Employee Theft of
<br /> Client Property$1,000,000-Retention$10,000
<br /> Cyber Liability-Carrier:Houston Casualty Company-Policy#H24NGP231006-02-Effective: 101112025-101112026-Each Claim Limit:$2,000,000-Aggregate:
<br /> $2,000,000-Deductible:$25,000
<br /> See Attached...
<br /> CERTIFICATE HOLDER ^VD CANCELLATION
<br /> By Tu Tran Nguyen at 11,54 am,:0at08,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City Of Santa Ana Digitally signed ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attention: PWA—CIP Engineering Tu !T ran,by Tu Trap
<br /> 20 Civic Center Plaza, M-26 Nquyen AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701 Ng Uyen' Date 2025.1D.o6
<br /> 11:55:07-3T06'
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
|