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HomeMy WebLinkAboutALLISON MECHANICAL, INC. (2)A-2021-162-03A MAYOR Valerie Amezcua MAYOR PRO TEM Thai Viet Phan COUNCILMEMBERS Phil Bacerra Johnathan Ryan Hernandez Jessie Lopez David Penaloza Benjamin Vazquez CITY OF SANTA ANA INSURANCE NOT ON FILE PUBLIC WORKS AGENCY WORK MAY NOT PROCEED 20Civic Center Pima •P.O.Box 1988 Santa Ana, California 92702 CITY CLERK W .sania-ana.orc DATE: NOV 0 4 2024 D,. PW PC ( Z) August 15, 2024 Allison Mechanical, Inc. CAI! 1968 Essex Court Redlands, CA 92373-8008 Attn: Fred Larkin, Project Manager CITY MANAGER Alvaro Nurlez CITY ATTORNEY Sonia R. Carvalho CITY CLERK Jennifer L. Hall Re: Extension of Agreement (A-2021-162-03) for On -Call HVAC Maintenance and Repair Services Pursuant to Section 3 ("Tenn") of the above -referenced Agreement, entered into by Allison Mechanical, Inc., and the City of Santa Ana, dated August 17, 2021 the time period of the Agreement is hereby extended for an additional two-year period, from August 17, 2024 through August 16, 2026. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, Nabil Saba, P.E. Executive Director, Public Works Agency CITY OF SANTA A at.r —Y Alvaro Nunez City Manager APPROVED AS TO FORM Andrea Garcia -Miller Assistant City Attorney ATTEST lnifer L all Cler Counci ALLISON MECHANICAL, INC. 444��� D Allison President SANTA ANA CITY COUNCIL Valene Amezaia Th.. V.1 Phan Benp.,. Vezauez Jessie Lopez PLJ Bamm Johneman Nrdn Hemandez David P.n.br Mayor Mayor Pro Tem, Wed 1 Wad2 Wadi Wed4 Weds Ward6 YafIPoZWa®Sdnladna ON IPh.a(Msadg.ena oN EaZoeezdunla.ana 0! ]910oaudaanla.ana om pbeCO A'@Sono anaO rv,hhprhndnftsan,,na oN doenelo,c,nla ena ON / A� " CERTIFICATE OF LIABILITY INSURANCE FDAIDDNYYY)(MM 11/6/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER SullivanCurtisMonroe Insurance Services (IRV) 2010 Main Street Suite 700 CONTACT NAME: Jennifer Bernal PHONE FAX A/C No Ext : 951 493 3315 A/C No : 951 493 3399 E-MAIL ADDRESS: jbernal@sullicurt.com INSURER(S) AFFORDING COVERAGE NAIC# Irvine, CA 92614 INSURERA: Middlesex Insurance Company 23434 www.SullivanCurtisMonroe.com License # OE83670 INSURED Allison Mechanical, Inc. 1968 Essex Court INSURER B INSURERC: INSURERD: Redlands, CA 92373 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 82630159 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/YYYY LIMITS A / COMMERCIAL GENERAL LIABILITY / / A0114876-004 11/1/2024 11/1/2025 EACH OCCURRENCE $1,000,000 CLAIMS-MADE 11/1 OCCUR A AGE To PREMIS ES (E. occurrDence)$1,000,000 V MED EXP (Any one person) $ 5,000 Deductible: $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $3,000,000 POLICY ✓� JE� LOC PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY AO114876-001 11/1/2024 11/1/2025 COMBINED (EaMBINEDtSINGLELIMIT $1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Comp / Coll Deductibles $$2,000 A �/ UMBRELLA LAB �/ OCCUR A0114876-006 11/1/2024 11/1/2025 EACH OCCURRENCE $5,000,000 v/ AGGREGATE $ 5,000,000 EXCESS LAB CLAIMS -MADE DED RETENTION $0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICE R/M EMBER EXCLUDED? FN] N/A A0114876-008 11/1/2024 11/1/2025 �/ STATUTE OERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: All Operations City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to General and Auto Liability and Workers' Compensation per the attached endorsement. 30 day notice of cancellation per the attached endorsement. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division, 4th Floor 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jennifer Bernal �Jntu*&S6_fllla'Q ACORD 25 (2016/03) The ACORD name and logo are registered APPROVED This 59 ALicate cancels and uApe ed A [primary] Jennifer Bernal I icat s. 7:49:3 By Cynthia Mora at 9:20 am, Nov 13, 2024 This certificate cancels and supersedes ALL previously issued certificates. AGENCY CUSTOMER ID: ALLISMEC LOC #: 4COR0� AnniTinNA1 REMARKS -Qr-wi=n 11 F AGENCY NAMED INSURED SullivanCurtisMonroe Insurance Services (IRV) Allison Mechanical, Inc. 1968 Essex Court POLICY NUMBER Redlands, CA 92373 CARRIER I NAIC CODE kDDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Santa Ana Risk Management Division, 4th Floor ADDRESS: 20 Civic Center Plaza Santa Ana CA 92702 Named Insureds: Allison Mechanical, Inc. Champ Management, Inc. Inland Sales & Leasing, LLC EFFECTIVE DATE: Paae of APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHMENT 82630159 1 ALLISMEC 1 2024-25 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal 1 11/6/2024 7:49:32 AM (PST) � Page 2 of 11 This certificate cancels and supersedes ALL previously issued certificates. Allison Mechanical, Inc. 11 /6/2024 POLICY NUMBER: A0114876-004 Effective Date: 11/1/2024 11/01/2025 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization to whom or which you are to insured in required provide additional status a written contract or written agreement executed prior to loss, except here such contract or agreement is prohibited by law. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 CG20100413 © ISO Properties, Inc., 2012 82630159 1 ALLISMEC 12024-25 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 11/6/2024 7:49:32 AM (PST) I Page 3 of 11 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 2 0 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 01 APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 Page 2 of 2 © ISO Properties, Inc., 2012 CG 20 10 04 13 82630159 1 ALLISMEC 12024-25 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 11/6/2024 7:49:32 AM (PST) I Page 4 of 11 This certificate cancels and supersedes ALL previously issued certificates. Allison Mechanical, Inc. 11 /6/2024 POLICY NUMBER: A0114876-004 FA ' COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR, ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 ©Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ Insured Copy 82630159 1 ALLISMEC 12024-25 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 11/6/2024 7:49:32 AM (PST) I Page 5 of 11 This certificate cancels and supersedes ALL previously issued certificates. Allison Mechanical, Inc. ifirf:ININ"l A0114876-004 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 82630159 1 ALLISMEC 12024-25 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 11/6/2024 7:49:32 AM (PST) I Page 6 of 11 This certificate cancels and supersedes ALL previously issued certificates. 11 /6/2024 POLICY NUMBER: Ao114s76-001 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Allison Mechanical, Inc. Endorsement Effective Date: 11/1/2024 SCHEDULE Name(s) Of Person(s) Or Organization(s): m or organization to whom or which you are required to provide this waiver of subrogation in a written contract or written agreement prior to loss, except where such contract or agreement is prohibited by law. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 82630159 I ALLISMEC 12024-25 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 11/6/2024 7:49:32 AM (PST) I Page 7 of 11 This certificate cancels and supersedes ALL previously issued certificates. Allison Mechanical, Inc. 11/01/2024 11/01/2025 11 /6/2024 POLICY NUMBER: A0114876-004 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) I Location And Description Of Completed Operations iAny person or organization to whom or which you are required to provide additional insured status in a written contract or written agreement executed prior to loss, except where such contract or agreement is prohibited by law. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. j A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to B. With respect to the insurance afforded to these additional insureds, the following is added to Section III -- Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. provide for such additional insured. APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 CG 20 37 04 13 0 Insurance Services Office, 82630159 1 ALLISMEC 12024-25 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 11/6/2024 7:49:32 AM (PST) I Page 8 of 11 This certificate cancels and supersedes ALL previously issued certificates. 11 /6/2024 POLICY NUMBER: A0114876-001 COMMERCIAL AUTO CA 76 01 06 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY - COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: Allison Mechanical, Inc. Endorsement Effective Date: 11/01/2024 SCHEDULE Name Of Person(s) Or Organ ization(s): As required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in: (1) Paragraph A.I. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2) Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. B. Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other auto insurance issued to the person or organization in the schedule under your policy provided that: (1) The person or organization is a Named Insured under such other insurance; and (2) Prior to the "accident' you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the person or organization. CA 76 01 06 15 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. APPROVED 82630159 1 ALLISMEC I 2024-25 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 11/6/2024 By Cynthia Mora at 9:20 am, Nov 13, 2024 This certificate cancels and supersedes ALL previously issued certificates. Allison Mechanical, Inc. A0114876-004 11/01/2024 11 /6/2024 IL 70 58 02 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION - CERTIFICATE HOLDERS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM COMMERCIAL AUTOMOBILE COVERAGE PARTS COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PARTS COMMERCIAL EXCESS/UMBRELLA LIABILITY COVERAGE FORM EMPLOYMENT RELATED PRACTICES LIABILITY POLLUTION LIABILITY COVERAGE ERRORS AND OMISSIONS COVERAGE FORM In the event we cancel this policy, we shall endeavor to also mail to the person(s) or organization(s) listed in the Schedule for this endorsement advance written notice of cancellation. This notification of cancellation of the policy is intended as a courtesy only. Our failure to provide such notification to the person(s) or organization(s) shown in the Schedule will not extend any policy cancellation date nor impact or negate any cancellation of the policy. This endorsement does not entitle the person(s) or organization(s) listed or described in the Schedule below to any benefit, rights or protection under this policy. Failure by us to provide this notice of cancellation to the person(s) or organization(s) listed or described in the Schedule below will not impose liability of any kind upon us. Any of these provisions that conflict with a law that controls the notice of cancellation of the insurance in this endorsement is changed by this statement to comply with the law. Schedule Person(s) or Organization(s) including mailing address: Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any accident, injury, loss or damage All other terms and conditions of this policy remain unchanged. APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 IL 70 58 02 14 Page 1 of 1 11 /6/2024 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Name: Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage Address: Description of Waiver: Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage JoblD: This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 11/01/2024 11/01/2025 Insured Allison Mechanical, Inc. Insurance Company WC 00 03 13 (Ed. 4-84) ©1983 National Council on Compensation Insurance. Policy No. A0114876-008 Endorsement No. Premium Countersigned by Page 1 of 1 APPROVED By Cynthia Mora at 9:20 am, Nov 13, 2024 82630159 ALLISMEC 12024-25 GLI, CAU, WCO, IC [primary] I Jennifer Bernal 111/6/2024 :49: n2 a ll %�f ll This certificate cancels and supersedes ALL previously issued certificates. / ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/27/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER SullivanCurtisMonroe Insurance Services (IRV) 2010 Main Street Suite 700 CONTACT NAME: Jennifer Bernal PHONE FAX A/C No Ext : 951 493 3315 A/C No): 951 493 3399 E-MAIL ADDRESS: jbernal@sullicurt.com INSURER(S) AFFORDING COVERAGE NAIC# Irvine, CA 92614 INSURERA: Middlesex Insurance Company 23434 www.SullivanCurtisMonroe.com License # OE83670 INSURED Allison Mechanical, Inc. 1968 Essex Court INSURER B : INSURERC: INSURERD: Redlands, CA 92373 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 87761143 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/YYYY LIMITS A / COMMERCIAL GENERAL LIABILITY / / A0114876-004 11/1/2025 11/1/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE 11/1 OCCUR A AGE To PREMIS ES (E. occurrDence)$1,000,000 V MED EXP (Any one person) $ 5,000 Deductible: $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $3,000,000 POLICY ✓� JE� LOC PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY AO114876-001 11/1/2025 11/1/2026 COMBINED (EaMBINEDtSINGLELIMIT $1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Comp / Coll Deductibles $$2,000 A �/ UMBRELLA LAB �/ OCCUR A0114876-006 11/1/2025 11/1/2026 EACH OCCURRENCE $5,000,000 v/ AGGREGATE $ 5,000,000 EXCESS LAB CLAIMS -MADE DED RETENTION $0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICE R/M EMBER EXCLUDED? FN] N/A A0114876-008 11/1/2025 11/1/2026 �/ STATUTE OERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: All Operations City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to General and Auto Liability and Workers' Compensation per the attached endorsement. 30 day notice of cancellation per the attached endorsement. Tu Tran Digitally signed by Tu Tran Nguyen Date: 205.11.0 Nguyen 116:5114-08'005 APPROVED [By CERTIFICATE HOLDER CANCELLATION Tu Tran Nguyen at 4:50 pm, Nov 05, 2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attention: Heidi Chou ACCORDANCE WITH THE POLICY PROVISIONS. 215 S. Center St., M-85 Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE - nn Jennifer Bernal © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 87761143 ALLISMEC 12025-26 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal 110/27/2025 10:32:19 AM (PDT) I Page 1 of 10 This certificate cancels and supersedes ALL previously issued certificates. AGENCY CUSTOMER ID: ALLISMEC LOC #: 4COR0� AnniTinNA1 REMARKS -Qr-wi=n 11 F AGENCY NAMED INSURED SullivanCurtisMonroe Insurance Services (IRV) Allison Mechanical, Inc. 1968 Essex Court POLICY NUMBER Redlands, CA 92373 CARRIER I NAIC CODE EFFECTIVE DATE: kDDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (03/16) HOLDER: City of Santa Ana Attention: Heidi Chou ADDRESS: 215 S. Center St., M-85 Santa Ana CA 92701 Named Insureds: Allison Mechanical, Inc. Champ Management, Inc. Inland Sales & Leasing, LLC Paae of ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHMENT 87761143 1 ALLISMEC 12025-26 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal 1 10/27/2025 10:32:19 AM (PDT) I Page 2 of 10 This certificate cancels and supersedes ALL previously issued certificates. Allison Mechanical, Inc. 10/27/2025 POLICY NUMBER: A0114876-004 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any owner, lessee, or contractor whom All Locations of the Named Insured you have agreed to include as an additional insured under a fully executed written contract or written agreement, provided that such was executed prior to an "occurrence", loss, injury or damage. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 87761143 1 ALLISMEC 1 2025-26 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal 1 10/27/2025 10:32:19 AM (PDT) I Page 3 of 10 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 1 Allison Mechanical, Inc. 10/27/2025 POLICY NUMBER: A0114876-004 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any owner, lessee, or contractor whom you All Locations of the Named Insured have agreed to include as an additional insured under a fully executed written contract or written agreement, provided that such was executed prior to an "occurrence", loss, injury or damage. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 87761143 1 ALLISMEC 1 2025-26 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal 1 10/27/2025 10:32:19 AM (PDT) I Page 4 of 10 This certificate cancels and supersedes ALL previously issued certificates. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 87761143 1 ALLISMEC 1 2025-26 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal 1 10/27/2025 10:32:19 AM (PDT) I Page 5 of 10 This certificate cancels and supersedes ALL previously issued certificates. CG 20 10 12 19 Allison Mechanical, Inc. A0114876-004 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 87761143 ALLISMEC 12025-26 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 10/27/2025 10:32:19 AM (PDT) I Page 6 of 10 This certificate cancels and supersedes ALL previously issued certificates. 10/27/2025 POLICY NUMBER: Ao114s76-001 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Allison Mechanical, Inc. Endorsement Effective Date: 11/1/2025 SCHEDULE Name(s) Of Person(s) Or Organization(s): m or organization to whom or which you are required to provide this waiver of subrogation in a written contract or written agreement prior to loss, except where such contract or agreement is prohibited by law. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 87761143 ALLISMEC 12025-26 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 10/27/2025 10:32:19 AM (PDT) I Page 7 of 10 This certificate cancels and supersedes ALL previously issued certificates. 10/27/2025 POLICY NUMBER: A0114876-001 COMMERCIAL AUTO CA 76 01 06 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY - COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: Allison Mechanical, Inc. Endorsement Effective Date: 11/01/2025 SCHEDULE Name Of Person(s) Or Organ ization(s): As required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in: (1) Paragraph A.I. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2) Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. B. Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other auto insurance issued to the person or organization in the schedule under your policy provided that: (1) The person or organization is a Named Insured under such other insurance; and (2) Prior to the "accident' you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the person or organization. CA 76 01 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 87761143 ALLISMEC 12025-26 GLI, CAU, WCO, UMC [primary] I Jennifer Bernal i 10/27/2025 10:32:19 AM (PDT) I Page 8 of 10 This certificate cancels and supersedes ALL previously issued certificates. Allison Mechanical, Inc. A0114876-004 11/01/2025 10/27/2025 IL 70 58 02 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION - CERTIFICATE HOLDERS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM COMMERCIAL AUTOMOBILE COVERAGE PARTS COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PARTS COMMERCIAL EXCESS/UMBRELLA LIABILITY COVERAGE FORM EMPLOYMENT RELATED PRACTICES LIABILITY POLLUTION LIABILITY COVERAGE ERRORS AND OMISSIONS COVERAGE FORM In the event we cancel this policy, we shall endeavor to also mail to the person(s) or organization(s) listed in the Schedule for this endorsement advance written notice of cancellation. This notification of cancellation of the policy is intended as a courtesy only. Our failure to provide such notification to the person(s) or organization(s) shown in the Schedule will not extend any policy cancellation date nor impact or negate any cancellation of the policy. This endorsement does not entitle the person(s) or organization(s) listed or described in the Schedule below to any benefit, rights or protection under this policy. Failure by us to provide this notice of cancellation to the person(s) or organization(s) listed or described in the Schedule below will not impose liability of any kind upon us. Any of these provisions that conflict with a law that controls the notice of cancellation of the insurance in this endorsement is changed by this statement to comply with the law. Schedule Person(s) or Organization(s) including mailing address: Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any accident, injury, loss or damage All other terms and conditions of this policy remain unchanged. IL 70 58 02 14 Page 1 of 1 10/27/2025 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule Schedule Name: Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage Address: Description of Waiver: Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage JoblD: This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 11/01/2025 11/01/2026 Insured Allison Mechanical, Inc. Insurance Company WC 00 03 13 (Ed. 4-84) ©1983 National Council on Compensation Insurance. Policy No. A0114876-008 Countersigned by,______ Endorsement No. Premium Page 1 of 1 87761143 ALLISMEC i 2025-26 GLI, CAU, WCO, IC [primary] I Jennifer Bernal 110/27/2025 10:32:19 AM (PDT) I Page 10 of 10 This certificate cancels and supersedes ALL previously issued certificates. CITY OF SANTA ANA Risk Management a division of Human Resources Managing Risk through Awareness and Action AFFIDAVIT OF EXEMPTION FOR PROFESSIONAL LIABILITY INSURANCE I, Don Allison, President ("Representative"), attest that I am an authorized (Name and Title of Vendor Representative) representative of Allison Mechanical, Inc. (Consultant/Company Name) possess the authority to legally bind Company. ("Company"), and In my capacity as Representative of Company, I represent and confirm the following, as relates to the agreement between Company and City of Santa Ana, agreement number A-2021-162-03 ("Agreement") to provide On -Call HVAC Maintenance and Repair Services ("Services"): (Services to be provided under agreement/contract) During the course and scope of Company's agreement with the City of Santa Ana, Company will not use the services of an expert necessitating professional liabilityerrors & omissions liability insurance coverage in the performance of Services to, for, or on behalf of City of Santa Ana. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum professional liability insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. 11 /05/2025 Date Don Allison President Print Name Title 909-478-5633 / dallison@allison1.net Contact Information, i.e., Telephone Number and/or Email Address Affidavit of Exemption for Professional Liability Insurance 11.12.2024