Laserfiche WebLink
CERTIFICATE OF LIABILITY INSURANCE DA E(MMi DN Y) <br /> THIS CERTIFICATE 1S 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 /> Gre Iln <br /> Edgewood Partners Ins Center PHONE COI Specialist FAX <br /> 3780 Mansell Rd. Suite 370 • 770.756.6599 arc No):770.756.6599 <br /> Alpharetta GA 30022 Ao6REss: greylingcertsQgreyling.com <br /> INSURER(S)AFFORDING COVERAGE NAIC 4 <br /> wsURER A:National Union Fire Ins Co of Pittsburg 19445 <br /> INSURED INSURERS: <br /> Psomas <br /> 865 South Figueroa Street INSURERC: <br /> Suite 3200 INSURER D: <br /> Los Angeles CA 90017 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1522473404 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 TYPE OF INSURANCE ADOL SUER POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS <br /> A X COMMERCIALGENERALLIABILITY GL526EI212 411/2026 4/112027 EACH OCCURRENCE $2.000.000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMISES Ea ccurrencel $50U,000 <br /> MED EXP(Any one porsan) $25,000 <br /> PERSONAL&ADV INJURY $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 <br /> POLICY JECT LOC PRODUCTS-COMPIOPAGG 54,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY CA4489706 4/1/2026 4/1/2027 COMBINEDSINGLELIMIT $2,000,000 <br /> Ea accident <br /> X ANYAUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> X HIRED X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> A WORKERS COMPENSATION WC72113158(AOS) 411/2026 41112027 X STATUTE ERH <br /> A AND EMPLOYERS'LIABILITY YIN WC72113159(CA) 4r1r2026 4/112027 <br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $2,000,000 <br /> OFFICERIMEM6EREXCLUDED? N I A <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $2,000,000 <br /> It yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,006,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> 2SAN051701;Santa Ana Agreement for RFP A-2023-075-07 On-call Engineering Services. <br /> City of Santa Ana its officers,officials,employees,and volunteers are named as Additional Insureds with respects to General&Automobile Liability where <br /> required by written contract.The above referenced liability policies are primary&non-contributory where required by written contract.Waiver of Subrogation in <br /> favor of Additional Insured(s)where required by written contract&allowed by law.Should any of the above described policies be cancelled by the issuing <br /> insurer before the expiration date thereof,we will endeavor to provide 30 days'written notice(except 10 days for nonpayment of premium)to the Certificate <br /> Holder. <br /> APPROVED -- - <br /> CERTIFICATE HOLDER CANCELLATION By ru Tran Nguyen of 11:59 am,Apr 06,2026 <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 /> Public Works Agency <br /> Santa Ana CA 92702-1988 AUTHORIZED REPRESENTATIVE/ jJ�_fir/ <br /> 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />