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(MMIDDIYYYY
<br /> a`©R" CERTIFICATE OF LIABILITY INSURANCE rATE
<br /> 41211202E )
<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: Certificate Department
<br /> Cavignac PHONE 619-234-6848 AIc No:619-234-8601
<br /> 451 A Street, Suite 1800 IA C No.ExU-E-MAIL
<br /> San Diego CA 92101 ADDRESS: certificates@cavignac.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC 0
<br /> INSURER A;Hartford Underwriters Insurance Co 30104
<br /> INSURED WESTCOA-14 INSURER IS Trumbull Insurance Company 27120
<br /> West Coast Code Consultants, Inc.12647 Alcosta Blvd., Ste 445 INSURER:Hartford Casualty Insurance Co 29424
<br /> San Ramon, CA 94583-5182 INSURER D:Underwriters at Lloyds London 85202
<br /> INSURER E:Arch Insurance Company 11150
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:740152810 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 OTHLR DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HLREIN IS SUBJECT TO ALL THE TLRMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS.
<br /> IOLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD SUER POLICY NUMBER MMID�rfYYY MMIDDIYYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 72SBWBSOB2L 4128/2026 4/2012027 EACH OCCURRENCE $21000T000
<br /> CLAIMS-MADE M OCCUR DAMAGES(RENTED
<br /> PREMISES Eaoeeurrence $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $4,000,000
<br /> POLICY JECT LOG PRODUCTS-COMP/OP AGG $4,000,000
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY Y Y 72UEGBC6531 4/28/2026 4128/2027 COMBINED SINGLE LIMIT $1,DDO,000
<br /> Ea accident
<br /> IX
<br /> ANY AUTO BODILY INJURY(Per person) S
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) S
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE S
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> S
<br /> A X UMBRELLA LIAR X OCCUR Y Y 72SBVVBSOB2L 4128/2026 4/2812027 EACH OCCURRENCE S4,000,000
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $4,000,000
<br /> DEC) I X RETENTION$ $
<br /> C WORKERS COMPENSATION Y 72VVEGBSDBOL 4/28/2026 4/2812027 X STATUTE ERH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANYPROPRIETOPJPARTNERIEXECUTtVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMSEREXCLUDED? NIA
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,060,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $1,000.000
<br /> ❑ Cyber Liability ES00740779273 4128/2026 412812027 Limit $1,000,0DO
<br /> E Pratessianal Liability Y PAAEP0180201 4/28/2026 4/28/2027 Each Claim $2,000,000
<br /> Aggregate $4,000,000
<br /> DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> RE:Project Name: On-Call Building Safety Consultant.Services 1 Project Number:A-2022-072-14.City of Santa Ana,its officers,officials,employees,and
<br /> volunteers are named as additional insureds as respects to General Liability and Automobile Liability per policy form.Primary and Non-Contributory coverage
<br /> applies to General Liability and Automobile Liability per policy form.Waiver of subrogation applies to General Liability,Automobile Liability,Professional
<br /> Liability and Workers Compensation per policy form.Excess/Umbrella policy follows form over underlying policies:General Liability,Auto Liability&Employers
<br /> Liability(additional insured and waiver of subrogation apply when afforded on underlying policies).Professional Liability-Claims made form,defense costs
<br /> included within limit.If the insurance company elects to cancel or non-renew coverage for any reason other than nonpayment of premium they will provide 30
<br /> days notice of such cancellation or nonrenewal.Professional Liability Retroactive Date: 4/28/2006
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By 7u Tran Nguyen at 1 f:2f ant,Apr Z2,2026
<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 /> Risk Management Division
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana, CA 92702
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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