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ACCN ? CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDfYYYY)
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHT oBr27rza25
<br /> S UPON THE CERTIFfGATE HOLDER.THIS
<br /> ORDED BY THE POLICIES
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFF
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING ORDEDINSUR BY 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 CME:A Accounts Team
<br /> NAME:
<br /> Scott&McCauley Insurance Agency PHONE (949)503-1953 FAX
<br /> 2 Ritz Carlton Drive
<br /> AIC No,
<br /> o E. : AfC,No.
<br /> E-MAIL COI sminsurancea enc com
<br /> Suite 204 ADDRESS: 9 y
<br /> INSURERIS)AFFORDING COVERAGE NAIC N
<br /> Dana Point CA 92629 AXIS Surplus Insurance Company 26620
<br /> INSURER A: p p y
<br /> INSURED INSURER B: The Continental Insurance Company 35289
<br /> Tait&Associates,Inc INSURER£: Valley Forge Insurance Company 20508
<br /> 701 Parkcenter Dr INSURER D: Colony Insurance Company 39993
<br /> INSURER E:
<br /> Santa GA 92705 INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: TAIT-25-26 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THATTHE POLICfES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO 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 POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDOIYYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY
<br /> EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE OCCUR PREMISES Ea occurrence) $ 25,000
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y Y SP002747-08-2025 09/01/2025 09/01/2026 2,000,000
<br /> PERSONAL&ADV INJURY $
<br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY ® PRO- ❑ LOG
<br /> OTHER: PRODUCTS-COMP/OP AGO $ 2,000,000
<br /> $
<br /> AUTOMOBILE LIABILITY e
<br /> D SINGLE LIMIT $ 1,000,000
<br /> X ANYAUTO ent
<br /> NJURY(Per person) $
<br /> g OWNED SCHEDULED Y Y 7034395486 09/01/2025 09101/20NJURY(Per accident) 3
<br /> AUTOS ONLY RUTOSHIRED NON-OWNED
<br /> ALJTOS ONLY AUTOS ONLY TY DAMAGEentUMBRELLA LIAR X OCCUR $ 5,000,000
<br /> CURRENCEA XEXCESS LIAR CLAIMS-MADE Y Y SX002748-08-2025 09/01/2025 09101/202ATE $ 5,000,000
<br /> DED RETENTION$
<br /> WORKERS COMPENSATION $
<br /> AND EMPLOYERS'LIABILITY Y f N X SEATUTE ERH
<br /> C ANYPROPRIMB R/PARTNERIEXECUTPVE ❑ NIA Y 7034395505 E.L.EACH ACCIDENT 1,000,000
<br /> (Mandatory
<br /> EXCLUDED? 09101/2025 09/01/2026 $
<br /> (Mandatoryib NH) 1,000,000
<br /> if yes,describe under E.L.DISEASE-EA EMPLOYEE S
<br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-PCLICY LIMIT $ 1,000,000
<br /> Professional LiablContractors Pollution ProfesSIPOII Ea Glaim 2,000,000
<br /> AID Excess Liability SP002747-082025/EX04295007 09/01/2025 09/01/2026 Ea Claim/Aggregate 4,000,000 X 5M
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:A-2023-088-13-Professional Engineering Services on an on-call basis for the City's Pubiic Works Agency.
<br /> City of Santa Ana,its officers,
<br /> agents,employees,contractors,special counsel,and representatives are included as an Additional Insured as required by a written contract or agreement
<br /> on the General Liability,Auto Liability,and Umbrella.Coverage is Primary&Non-Contributory when required by a written contract or agreement with the
<br /> named insured.Blanket Waiver-of-Subrogation is granted in favor of the Additional Insured with respect to the General Liability,Auto Liability,and Workers'
<br /> Compensation when required by written contract or agreement.Thirty(30)days'notice of cancellation with ten(10)days'notice for nonpayment of premium Tu Trana9^ea rW
<br /> is provided to the certificate holder.
<br /> Nguye W
<br /> CERTIFICATE HOLDER APPROVE©
<br /> CANCELLATION
<br /> 8y Tu Tran Nguyen at 2:56 pm,Aug 27,2�25
<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 Attn:Public Works Agency ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> GIP/Design Engineering
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> 0 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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