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AC ® DATE(MMIDDIYYYY) <br /> �� CERTIFICATE OF LIABILITY INSURANCE 3/12I2026 <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 /> .Me <br /> Regina Caindo <br /> Arthur J. Gallagher Risk Management Services, LLC PHONE 425-586-1034 ar No): <br /> FAX <br /> 10900 NE 8th St. <br /> Ste 750 AoDResS: re ina caindoyQaiq.corn <br /> Bellevue WA 98004 INSURER(S)AFFORDING COVERAGE NAIL# <br /> INSURER A:National Union Fire Insurance Company of Pittsburg19445 <br /> INSURED INSURER B:New Hampshire Insurance Company 23841 <br /> Shannon&Wilson, Inc. <br /> ATTN: Travis Deane INSURER C <br /> 100 N. First Street, Suite 200 INSURER D <br /> Burbank CA 91502 INSURERE: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1558493079 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDDPOLICYIYYYY MMIDWYYYY LIMITS <br /> A X COMMERCIALGENERALLIABILITY Y Y 5180256 311/2026 3/112027 EACH OCCURRENCE $2,000,000 <br /> � OCCUR DAMAGE TO S(RELATE❑ <br /> CLAIMS-MADE <br /> PREMISES Ea occurrence) 3300,000 <br /> MED EXP(Any one person) 325,000 <br /> PERSONAL&ADV INJURY S 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S4,000,000 <br /> POLICY O jE� LOC PRODUCTS-COMP/OP AGG 54.000,000 <br /> OTHER: S <br /> A AUTOMOBILE LIABILITY Y Y 2961686 31112026 3/1/2027 COMBINED SINGLE LIMIT $2 000,000 <br /> Ea accident <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED F7 SCHEDULED AUTOS ONLY BODILY INJURY(Per accident) $ <br /> AUTOS <br /> HIRED HNON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per.accident <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB H.CLAIMS-MADE AGGREGATE $ <br /> ❑ED RETENTION$ $ <br /> A WORKERS COMPENSATION Y WC066656652 31112D26 3/112027 X STATUTE OERH <br /> B AND EMPLOYERS'LIABILITY YIN WCD66656651 311/2026 3f112027 <br /> ANYPROPRIETORIPARTNERIEXECUTIVE 7] NIA E.L EACH ACCIDENT $2,000,D00 <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory in NHI EL,DISEASE-EA EMPLOYEE $2,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 2,000,0D0 <br /> DESCRIPTION OE OPERATIONS I LOCATIONS)VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Re Workers'Comp-in Monopolistics,Employers'Liability only <br /> City of Santa Ana,its offers,officials,employees and volunteers are included as Additional Insured for General Liability(per CG2010 and CG2037),AUte as <br /> respects operations of the Named Insured and where required by written contract.GL,AL Primary and Non-Contributory is included where required by written <br /> contract.Waiver of Subrogation is included where required by written to contract. RE:City of Santa Ana Can-Call Engineering Services.S&W Job No. 111155. <br /> [APPROVED <br /> By Tv Tran Nguyen at 4:77 prim,Ma,12,2t72B <br /> CERTIFICATE HOLDER CANCELLATION <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 /> Attn: Jennifer L. Hall ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza(M-30) <br /> PO Box 1988 AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92702 <br /> USA f�c J,,-� <br /> O 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />