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AC" CERTIFICATE OF LIABILITY INSURANCE 712131/2025 <br /> E(MMfDDIYYYY) <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 /> AssuredPartners Design Professionals Insurance Services, LLC NAME: Maurice Thornton <br /> PHONE . 510-272-1476 FAX <br /> 3697 Mt. Diablo Blvd., Suite 230 wC No <br /> Lafayette CA 94549 n DRLES& DesignProCerts@AssuredPartners.com <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> License#:6003745 INSURER A:Underwriters at Lloyd's,London 32727 <br /> INSURED SHAN&VVI-03 INSURER B <br /> Shannon &WIson, Inc. <br /> 100 N. First St., Suite 200 INSURER C <br /> Burbank CA 91502 INSURER D <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:186180691 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 ADDL SUaR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDOIYYYY LIMITS <br /> COMMERCIALGENERALLIABILITY EACH OCCURRENCE 5 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE OCCUR PREMISES Ea oCCUrrence S <br /> MED EXP(Anyone person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE S <br /> POLICY� PRO- <br /> JECT LOD PRODUCTS-COMPIOPAGG S <br /> OTHER: S <br /> AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT S <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> 11 <br /> UMB RELLA LIAB OCCUR EACH OCCURRENCE S <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE S <br /> DIED RETENTION$ $ <br /> WORKERS COMPENSATION PER CTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER <br /> ANYPROPRIETORIPARTNERIEXEC UTI V F <br /> OFFICERIMEMSER EXCLUDED? N f A E.L..EACH ACCIDENT $ <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> A Professional Liability& B0507BN2600152 1/1/2026 1/1/2027 $2,000,000 per Claim <br /> Contractors Pollution Liability $2,000,000 Annual Aggregate <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101.,Additional Remarks Schedule,may be attached if more space is required) <br /> Project Name: City of Santa Ana On-Call Engineering Services <br /> S&W Job No.: 111155 <br /> Location: Santa Ana,CA <br /> Professional Liability Retroactive Date: 1/1/1954 [A�PP�ROVEDInsurance coverage includes waiver of subrogation per the attached policy form TTran Nguyen at 4:17 pm,Mar 12,2d2s <br /> CERTIFICATE HOLDER CANCELLATION 30 Day Notice of Cancellation <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 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attn: Jennifer L, Hall <br /> 20 Civic Center Plaze (M-30) AUTHORIZED REPRESENTATIVE <br /> PO Box 1988 <br /> Santa Ana CA 92702-1988 <br /> O 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />