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CERTIFICATE OF LIABILITY INSURANCE DATE 0 911 1025 1912 0 2 5
<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 ACCOunts Team
<br /> NAME:
<br /> Scott&McCauley Insurance Agency PHONE (949)503-1953 FAX
<br /> AIC No Ext: A1C,No
<br /> 2 Ritz Carlton Drive E-MAIL COI@a sminsuranceagency.com
<br /> ADDRESS:
<br /> Suite 204 INSURER(S)AFFORDING COVERAGE NAIL tk
<br /> Dana Point CA 92629 INSURER A: AXIS Surplus Insurance Company 26620
<br /> INSURED INSURER B: The Continental Insurance Company 35289
<br /> Tait&Associates,Inc INSURERC: Valley Forge Insurance Company 20508
<br /> 701 Parkcenter Dr INSURER D: Colony insurance Company 39993
<br /> INSURER E:
<br /> Santa CA 92705 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: TAlT MSTFR 25-26 REVISION NUMBER:
<br /> THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TQTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS
<br /> CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP
<br /> LTR INSO WVD POLICY NUMBER MMIDDIYYYY) (MMIDDrffYYI LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,OOC
<br /> CLAIMS-MADE � OCCUR PREMISES Fa Occurrence $ 25,000
<br /> MED EXP(Any one person) S 5,000
<br /> A Y Y SP002747-08-2025 09/01/2025 09/0112026 PERSONAL&ADV INJURY s 2,000,000
<br /> GEN'L AGGREGATE LIMITAPPLIES PER. GENERAL
<br /> $AGGREGATE S 2,000,000
<br /> POLICY ❑X PRa.ECT ❑ LOC PROD 2,000,000
<br /> J
<br /> OTHER: S
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT �. 1,000,000
<br /> Ea accident
<br /> �( ANYAU70 BODILY INJURY(Per person) S
<br /> B OWNED SCHEDULED Y Y 7034395486 0910112025 0910112C26 BODILY INJURY(Per accident) S
<br /> AUTOS ONLY AUTOS
<br /> HIREO NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per aGGidertit
<br /> UMBRELLA LIAS X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> A EXCESS LIAB CLAIMS-MADE Y Y SX002748-08-2025 09/01/2025 09/01/2026 AGGREGATE $ 5,000.000
<br /> NDEO I I RETENTION S $
<br /> WORKERS COMPENSATION PER OTH
<br /> YIN -
<br /> AND EMPLOYERS'LIABILITY X STATUTE ER
<br /> C ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S 1,000,O CO
<br /> OFFICERIMEMBER EXCLUDED? NIA Y 7034395505 09/0112025 09101l2026
<br /> IMandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000
<br /> Professional LiablContractors Pollutlon Profess/Poll Ea Claim 2,000,000
<br /> A/D Excess Liability SP002747-082025/EX04295007 09/0112025 09/01/2026 La Claim/Aggregate 4,000,000 X 51VI
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS r VEHICLES (ACORD 101,Addltional Remarks Schedule,maybe attached If more space is required)
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are additional insureds per written contract or agreement.
<br /> The certificate holder is included as an Additional Insured as required by a written contract or agreement on the General Liability,Auto Liability,and
<br /> Umbrella.Coverage is Primary&Non-Contributory when required by a written contract or agreement with the named insured.Blanket Waiver-of-Subrogation
<br /> is granted in favor of the Additional Insured with respect to the General Liability,Auto Liability,and Workers'Compensation when required by written
<br /> contract or agreement.Umbrella follows form over General liability,Auto liability,Employers liability,pollution and professional liability.Thirty(30)days'
<br /> notice of cancellation with ten(10)days'notice for non-payment of premium is provided to the certificate holder.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Tu Tran ° 1rallysignedby THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> r�rran25.09,,2 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana PWA-Facilities Nguyen
<br /> �� Date:2925.9939
<br /> V g u ye n 082506-07W
<br /> 20 Civic Center Plaza,M-ti
<br /> AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> ©1988-2015ACORD CORPORATION. All rights reserved,
<br /> ACORD 25(2018l03) APPROVEDare registered marks of ACORD
<br /> By Tu Tran Nguyen at 8:24 am,Sep 29,2025
<br />
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