|
�� CERTIFICATE OF LIABILITY INSURANCE FDATE(MMiDDIYYYY)
<br /> �s 5/19/2026
<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 1NSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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 endorsements),
<br /> PRODUCER CONTACT
<br /> BHIS-Colossus-Alkeme Insurance NAME: Bonnie Me for
<br /> 1204 E Yorba Linda Blvd PH°"E Extl, 619-908-6351 Falc No):
<br /> Placentia CA 92870 EMAIAooRL
<br /> Ess: bme iar alkemeins.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A: Infinity Select Insurance Co 20079
<br /> INSURED BRUCAND-03 Bruce Anderson Enterprises, Inc. dba A's Construction INSURERB:Associated Industries Insurance Company, Inc. 23140
<br /> 1662 West McFadden Ave INSURER C:Ategrity Specialty Insurance Company 16427
<br /> Santa Ana CA 92704 INSURERD:Scottsdale Insurance Company 41297
<br /> INSURER E:State Compensation Insurance Fund of California 35076
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:812084193 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 SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE D POLICYNUMBER fMMIDDiYYYYI IMMIDDIYYYYILIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY AES126773501 11/18/2025 11118/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE F-KI OCCUR DAMAGE RENTED—
<br /> PREMISES Ea occurmnco $100,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> PRO-
<br /> POLICY X JECT LOC PRODUCTS-COMPIOP AGG $2,000,DOD
<br /> OTHER: $
<br /> A AUTOMOBILELIABILITY 50029783401 1/10/2026 1/10/2027 O.
<br /> accldept5lNOLE LIMIT $1,000,D00
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED X SCHEDULED BODILY INJURY(Per accident $
<br /> AUTOS ONLY AUTOS }
<br /> X HIRED X NON-OWNED PROPERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> $
<br /> D UMBRELLALIAB X OCCUR CXS4067120 10/21/2026 11/18/2026 EACH OCCURRENCE $2,000,000
<br /> X EXCESS LIAB CLAIMS-MADE
<br /> AGGREGATE $2,000,000
<br /> DED X RETENTION$ $
<br /> E WORKERS ANbEMPL0YER5ELIABILITY YIN 9352130 1/10/2026 1/10/2027 X STATUTE ORH
<br /> ANYPROPRIETORIPARTN ERIEXECUTI VE
<br /> OFFICEWMEMBEREXCLUDED? ❑ N 1A E.L.EACH ACCIDENT $1,000,000
<br /> (Mandatory In NH)
<br /> If yes,descr€be under E.L.DISEASE_EA EMPLOYEE $1,OOD,D00
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> C Pollution Liabilly G48784586 001 10/6/2025 10/6/2026 Each Condition 1,000,000
<br /> Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Addltlonal Remarl(a Schedule,may be attached if more space is required)
<br /> Project#26-6001 &26-6002 CIVIC CENTER WAYFINDING
<br /> City of Santa Ana,Its City Council, ifs officers,officials,employees,agents and volunteers are additional insureds including primary non-contributory and waiver
<br /> of subrogation in regards to general liability as respects to insureds operations per forms CG2010,CG2037,CG2001, CG2402 as required by written contract
<br /> with the named insured prior to an occurrence and subject to policy terms and conditions.
<br /> [GENERAL LIABILITY FORMS ARE BEING PROCESSED AND WILL FOLLOW SHORTLY WITH AN AMENDED CERTIFICATE AND FORMS ATTACHED)
<br /> City of Santa Ana,its City Council,ifs officers,officials,employees, agents and volunteers are additional insureds for Ongoing and completed operations
<br /> See Attached...
<br /> CERTIFICATE HOLDER -APPROVED CANCELLATION
<br /> 8y Tu Fran Nguyen at fl.15 am,.May 27 2t7Z6 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 /> Attm Risk Management
<br /> 20 Civic Center Plaza M-21 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701 i
<br /> O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
|