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CERTIFICATE OF LIABILITY INSURANCEFi5771,1,liit725 YYYY)
<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.If
<br /> SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this 61
<br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> e
<br /> PRODUCER CONTACT 4)
<br /> Aon Risk Insurance Services west, Inc. NAME: 'a
<br /> PHONE FAX
<br /> (866) 283-7122 Los Angeles CA Office (Arc.No.Ext): AIC.No.: (800) 363-OID5
<br /> 707 wi Ishire Boulevard E-MAIL a
<br /> Suite 2600 ADDRESS: o
<br /> Los Angeles CA 90017-0460 USA =
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> ENSURED INSURER A: Safety National casualty Corp
<br /> 17885 von Korman Ave., Suite 500 15105
<br /> Tetra Tech, Inc INSURERB: Allied world Surplus Lines Insurance Co 24319
<br /> Irvine CA 92614 USA INSURER0:. American International Group UK Ltd AA1120187
<br /> INSURER D:
<br /> INSURER i
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 5701 1 61 59764 REVISION NUMBER:
<br /> THdS 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.LIMfTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
<br /> LTR TYPE OF INSURANCE POLICY EFF
<br /> INSD WVD I POLICY NUMBER
<br /> A MM1D01YYYY MM1DDlYYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY Y Y GL 7 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE FX�OCCUR T $1,OOD,000
<br /> PREMISES Ea occurrence
<br /> X X,C,U Coverage MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMITAPRLIE9 PER: GENEHALAGGREGATE $4,000,040
<br /> CD
<br /> POLICY ! x I PRO- LOG LO
<br /> T
<br /> L jJECT PRODUCTS-COMi AGG $4,000,000 to
<br /> OTHER:
<br /> O
<br /> A AUTOMOBILE LIABILITY Y Y CA 6676805 10/01/2025 10/01/2026 COMBINED SINGLE LIMIT 'f
<br /> Ea accident) $1,000,000
<br /> X ANYAUTO BODILY INJURY(Per person) 4
<br /> OWNED SCHEDULED Z
<br /> AUTOS ONLY
<br /> AUTOS BODILY INJURY(Per accident) 4)
<br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE 18
<br /> ONLY AUTOS ONLY Per accidantl ;F
<br /> C X UMBRELLALIAa X OCCUR 627$5232 10/01/2025 10101/2(J26 EACH OCCURRENCE $5,0007500 L)
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $S,OOQ,OOO
<br /> OED RETENTION
<br /> A WORKERS COMPENSATION AND Y LDC406 9970 10/01/2025 10/01/2026 PER STATUTE CTH-
<br /> EMPLOYERS'LIABILITY YIN AOS X ER
<br /> A ANY PROPRIETOR f PARTNER 1 EXECUTIVE N OFFICERIMEMBER EXCLUDED? ❑ NIA P54068969 10/01/2025 10/01J2026 E.L.EACH ACCIDENT S1,000,0
<br /> (Mandatory in Ni W1 EL.DISEASE-EA EMPLOYEE
<br /> If yes,describe under S1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,QQQ,QQQ
<br /> El Contractors and 03120276 10/01/2025 10/01/2026 Each Claim $2,000,000
<br /> Prof Prof/Poll-Claims Made Cov Aggregate $2,004,000
<br /> SIR applies per policy terns & condi ions
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space le required)
<br /> RE: Agreements Numbers: A-2023-088-02, A-2023-033-01 and A-2023-034-01, Stop Gap Coverage for the following States: OH, ND,
<br /> WA, WY. The City, its officers, officials, employees and volunteers are included as Additional Insured in accordance with the polioyy provisions of the General Liability and Automobile Liability policies as required by written contract. General
<br /> Liability and Automobile Liability policies evidenced herein are Primary and Nan-Contributory to other insurance available to
<br /> an Additional Insured, but only in accordance with the policy provisions as required by written contract. A waiver of
<br /> subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability,
<br /> Automobile Liability and workers' compensation policies as required by written contract, should General Liability and
<br /> CERTIFICATE HOLDER APPROVED111v- ,
<br /> ANCELLATION
<br /> By Tu Tran Nguyen at 10.52 am25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br /> POLICY PROVISIONS.
<br /> City Of Santa Ana Tu Trad YAUTHORIZED REPRESENTATIVE Ily-a
<br /> Attn: Public Works Agency nCIP/Design Engineering 120CivicCenter Plaza, M-3b NgUYe0 (]%� (.R_� Qii (�17�
<br /> Santa Ana Ga 92701 USA 9S ✓�! ✓ {�� iJ
<br /> c@1988.2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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