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HomeMy WebLinkAboutTRB & ASSOCIATES (2) INSORl NCE 0,j HLE A-2022-072-12A '4ORK MAY PROCEED 01 pB L UNITI[ INSLIRANCEEXPIPz_S Vilj�r6i� to ',iTY CLERK MAYOR IAFE: MAY 13 Z08 CITY MANAGER Valerie Amezcua �a Alvaro Nunez MAYOR PRO TEM i` CITY ATTORNEY Benjamin Vazquez i Sonia R.Carvalho COUNCILMEMBERS CITY CLERK Phil Bacerra Jennifer L.Hall Johnathan Ryan Hernandez Jessie Lopez David Penaloza Thai Viet Phan CITY OF SANTA ANA PLANNING AND BUILDING AGENCY 20 Civic Center Plaza•P.O.Sox 1988 Santa Ana,California 92702 www.sania-ana.ore April 29, 2025 TRB and Associates, Inc. Attn: Todd Bailey 3180 Crow Canyon Place, Ste, 216 San Ramon,CA 94583 Re: Extension of Agreement A-2022-072-12 for On-Call BuildinF Safe Inspection Services Pursuant to Section 3 ("Terun") of the above-referenced Agreement, entered into by TRB and Associates, Inc.("Consultant")and the City of Santa Ana, dated May 17, 2022,the time period of the Agreement is hereby extended for an additional one-year period until May 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, Ali Pezeshkpour r Acting Executive Director Planning and Building Agency CITY OF LS A ANA ATTEST lvaro Nutiez Jennifer L. City Manager erk APPR V S TO CONSULTANT Melissa M. Crosthwaite �odtl- alley Senior Assistant City Attorney President SANTA ANA CITY COUNCIL Valerie Am—. Benjamin Vazquez Thal VifttPhan: Jessie Lopez Phil Bacerra JatmaOran Ryan Hernandez PaVid Penaluza may- AFaynr Pra Tern-Ward 2 Ward i Ward 3 Ward 4 Ward 5 ward& Vanlezd.a sanla-8n8.prd. yaSSluQZn¢5anla-8na(Sfa IBhangpsania!ana,m4 jeSSleleneZ(158nla ena.m" dh3[eRaC158n1a-an8 qm jryanl4drndhdBZ I�d58rl�a ana a g deenaloFd&d5anla,ana aro 0 -F ACOR" CERTIFICATE OF LIABILITY INSURANCE DATEIMMrooYYYY) 1 10 6120 24 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 CONSTITUTEA 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 CONTACT David Saechao-RM NAME: The Liberty Company Insurance Brokers PHONE Ext: (888)918-3960 Arc No Lic#OD79653 E-MAIL David.Saechao@libertycompany.com ADDRESS: 5955 De Sato Ave,Ste 250 INSURER(S)AFFORDING COVERAGE NAIC# Woodland Hills CA 91367 INSURER A: Continental Casualty Company 20443 INSURED INSURER B: Valley Forge Ins Co 20508 TRB AND ASSOCIATES INSURER c: Transportation Insurance Co 20494 3180 CROW CANYON Pt_#216 INSURER D: Employers Preferred Ins.Co. 10346 INSURER E: U.S.Specialty Insurance Co. 29599 SAN RAMON CA 94583 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2411541740 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIODIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 CLAIMS-MADE ®OCCUR PREMISES Ea ggcu D nce $ 1,OOODAWGE ,D00 MED EXP(Any one person) $ 10,QOG A Y 2097186534 11/10/2024 11/10/2025 -PERSONAL sADVINJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4.000,000 J X POLICYY rC 4,000,000 EGT LOC PRODUCTS-COMPIOPAGG S X1 OTHER: Cyber liability occur/aggregate $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) S B X OWNED SCHEDULED Y 7013446068 11/1012024 11/1012025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X' HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident Medical payments $ 5.000 IDX UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 2,OQQ,000 C EXCESS LIAS CLAIMS-MADE 7036238862 11/10/2024 11/10/2025 AGGREGATE $ 2,000,000 DIED X RETENTION$ 0 5 WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S 1,000,000 OFFICERIMEMBER EXCLUDED`? NIA Y EIG463819504 1111 D12024 11/10/2025 (Mandatory in NHI F.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 per occ 2,000,000 E profesisonal liability USS2435165 11/1012024 11/1012025 aggregate 2,000,000 retention 25,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,maybe attached if more space is required) Whereby required by written contract or agreement,City of Santa Ana,its officers,employees,agents and representatives are included as additional insured with respect to general liability and auto liability.Insurance is primary and non-contributory.Waiver of subrogation applies to workers compensation. APPROVED By Cynthia Mora at 5:30 pm, Dec 02, 2024 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Manangement Division 20 Civic Center Plaza,4th FI AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 O 198�8-2015�ACJORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date PAESL PAESL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000 $172,00 Ref EDescription Coverage Code Form No. Edition Date ent Practices Liability Insurance EPLI LimiLimit 2 Limit 3 Deductible Amount Deductible Type Premium 10,0 Ref# Description Coverage Code Form No. Edition Date Uninsured motorist combined single limit UMCSL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 Ref# Description Coverage Code Form No. Edition Date Umbrella(C) CUMBR Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 2,000,000 10.000 Ref# Description Coverage Code Form No. Edition Date Adjst.to reconcile-exp mod.premium AREM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $2,045.00 Ref# Description Coverage Code Form No. Edition bate Schedule rate adjustment SRA Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $2,577.00 Ref# Description Coverage Code Form No. Edition Date Add'I for policy minimum premium APMP Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $144.00 Ref# Description Coverage Code Form No. Edition Date Uninsured Employee Benefits Trust Fund UEBTF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $4.00 Ref# Description Coverage Code Form No. Edition Date Increased employer's liability INEL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date Merit Surcharge MERIT Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$6.00 Ref# Description Coverage Code Form No. Edition Date LECF LECF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $62.00 OFADTLCV A PPRO�V/CJ'1 Copyright 2001,AMS Services,Inc. By Cynthia Mo�rra at 5:30 pm, Dec 02, 2024 ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date Uninsured Employee Benefits Trust Fund UFBTF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $13.00 Ref# Description Coverage Code Form No. Edition Date Premium discount PDIS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$4.00 Ref# Description Coverage Code Form No. Edition Date Schedule rate adjustment SRA Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $33.00 Ref# Description Coverage Code Form No. Edition Date Expense constant EXCNT Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $160.00 dition Date Ref# Description Coverage Code Form No. E Premium discount PDIS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$4.00 Ref# Description Coverage Code Form No. Edition Date Increased employer's liability INEL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $4.00 Ref# Description Coverage Code Form No. Edition Date OSHEF OSHEF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $63.00 ition Date Ref# Description Coverage Code Form No. Ed Assessment Fund ASMNT Limit i Limit 2 Limit 3 Deductible Amount Deductible Type Premium $138.00 Ref# Description Coverage Code Form No. Edition Date Surcharges SURC Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $36.00 Ref# Description Coverage Code Form No. Edition Date Schedule rate adjustment SRq Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$86.00 Ref# Description Coverage Code Form No. Edition Date Merit Surcharge MERIT Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $26.00 rOFADTLCV JAPPROVED Copyright 2001,AMS Services,Inc. By Cynthia Mora at 5:30 PM, Dec 02, 2024 ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date Waiver of Subrogation WVSUB Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $251.00 Ref# Description Coverage Code Form No. Edition Date YBYI YBYI Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $979.00 Ref# Description Coverage Code Form No, Edition Date Increased employer's liability INEL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $2.00 Ref# Description Coverage Code Form No. Edition Date Premium discount PHIS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$273.00 Ref# Description Coverage Code Form No. Edition Date Second Injury Fund 2NDIN Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $213.00 Ref# Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount 7 eductible Type Premium Ref# Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount 7Deductible Type Premium Ref# Description Coverage Code For No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium tO�ADTLCV APPROVED Copyright 2001,AMS Services,Inc. By Cynthia Mara at 5:30 pm, Dec 02, 2024 SB146916E (Ed. 07-20) exhaust the applicable Limit of Insurance, we will then pay the difference between the actual cash value and the replacement cost, provided that the repair or replacement is completed: (i) Within 12 months after we pay the actual cash value; or (i i) Within 36 months after we pay the actual cash value if the loss or damage relates to a state of emergency under California law; The following provision applies to real property which is used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household personal property in a residential unit: If you, acting in good faith and with reasonable diligence, encounter a delay or delays in approval for, or reconstruction of, the residence that are beyond your control, we shall provide one or more additional extensions of six months for good cause. Circumstances beyond your control include, but are not limited to: (i) Unavoidable construction permit delays; (H) The lack of necessary construction materials; or (iii) The unavailability of contractors to do the necessary work. Nothing in this paragraph (b) constitutes a waiver of our right to deny the claim for any valid reason or to restrict payment in cases of suspected fraud. (7) Tenants Improvements and betterments at: (a) Replacement cost in accordance with the terms set form in paragraph (1)(b)above. (b) A proportion of your original cost if the property is not repaired or replaced. We will determine the proportionate value as follows: (i) Multiply the original cost by the number of days from the loss or damage to the expiration of the lease; and (ii) Divide the amount determined in (i) above by the number of days from the installation of improvements to the expiration of the lease. If your lease contains a renewal option, the expiration of the renewal option period will replace the expiration of the lease in this procedure. (c) Nothing if others pay for repairs or replacement. 4 B. The Businessowners Common Policy Conditions are amended as follows: 0 1. Paragraphs A.2.and A.3. Cancellation are replaced by the following: 2. All Policies In Effect For 60 Days Or Less If this policy has been in effect for 60 days or less, and is not a renewal of a policy we have previously issued, we may cancel this policy by mailing or delivering to the first Named Insured at the mailing address shown in the policy and to the producer of record, advance written notice of cancellation, stating the reason for cancellation, at least: a. 10 days before the effective date of cancellation if we cancel for: (1) Nonpayment of premium; or (2) Discovery of fraud by: (a) Any insured or his or her representative in obtaining this insurance; or (b) You or your representative in pursuing a claim under this policy. b. 30 days before the effective date of cancellation if we cancel for any other reason. SB146916E (07-20) APPROVED Page 2 of 6 IB`lyrCynnthia Mora at 5:30 pm, Dec 02, 2024 SB146916E (Ed. 07-20) 3. All Policies In Effect For More Than 60 Days a. If this policy has been in effect for more than 60 days, or is a renewal of a policy we issued, we may cancel this policy only upon the occurrence, after the effective date of the policy, of one or more of the following: (1) Nonpayment of premium, including payment due on a prior policy we issued and due during the current policy term covering the same risks. (2) Discovery of fraud or material misrepresentation by: (a) Any insured or his or her representative in obtaining this insurance; or (b) You or your representative in pursuing a claim under this policy. (3) A judgment by a court or an administrative tribunal that you have violated a California or Federal law, having as one of its necessary elements an act which materially increases any of the risks insured against. (4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or your representative, which materially increase any of the risks insured against. (5) Failure by you or your representative to implement reasonable loss control requirements, agreed to by you as a condition of policy issuance, or which were conditions precedent to our use of a particular rate or rating plan, if that failure materially increases any of the risks insured against. (6) A determination by the Commissioner of Insurance that the: (a) Loss of, or changes in, our reinsurance covering all or part of the risk would threaten our financial integrity or solvency; or (b) Continuation of the policy coverage would: (i) Place us in violation of California law or the laws of the state where we are domiciled; or (ii) Threaten our solvency. (7) A change by you or your representative in the activities or property of the commercial or industrial enterprise, which results in a materially added, increased or changed risk, unless the added, increased or changed risk is included in the policy. b. We will mail or deliver advance written notice of cancellation, stating the reason for cancellation, to the first Named Insured, at the mailing address shown in the policy, and to the producer of record, at least: (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium or discovery of fraud; or (2) 30 days before the effective date of cancellation if we cancel for any other reason listed in Paragraph 3.a. 2. The following provision is added to Paragraph A. Cancellation: 7. Residential Property This provision applies to coverage on real property which is used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household personal property in a residential unit. If such coverage has been in effect for 60 days or less, and is rot a renewal of coverage we previously issued, we may cancel this coverage for any reason, except we may not cancel this policy solely because: a. Corrosive soil conditions exist on the premises; or b. The first Named Insured has: (1) Accepted an offer of earthquake coverage; or (2) Cancelled or did not renew a policy issued by the California Earthquake Authority (CEA) that included an earthquake policy premium surcharge. SB146916E (07-20) e APPROVED Copyright,CNA All Rights Rese By Cynthia Mora at 5:30 pin, Dec 02, 2024 SB146916E (Ed. 07-20) However, we shall cancel this policy if the first Named Insured has accepted a new or renewal policy issued by the CEA that includes an earthquake policy premium surcharge but fails to pay the earthquake policy premium surcharge authorized by the CEA. If a state of emergency under California Law is declared and the residential property is located in any ZIP Code within or adjacent to the fire perimeter as determined by California Law, we will not cancel this Policy for one year, beginning from the date the state of emergency is declared, solely because the dwelling or other structure is located in an area in which a wildfire has occurred. However, we may cancel: a. When you have not paid the premium, at any time letting you know at least 10 days before the cancellation takes effect; b. If willful or grossly negligent acts or omissions by the named insured, or his or her representatives, are discovered that materially increase any of the risks insured against; or c. If there are physical changes in the property insured against, beyond the catastrophe damaged condition of the structures and surface landscape, which result in the property becoming uninsurable. 3. Paragraph C. Concealment, Misrepresentation Or Fraud is replaced by the following with respect to loss or damage caused by fire: We do not provide coverage to the insured who, whether before or after a loss„ has committed fraud or intentionally concealed or misrepresented any material fact or circumstance concerning: a. This policy; b. The Covered Property; c. That insured's interest in the Covered Property; or d. A claim under this policy. 4. Paragraph C. Concealment, Misrepresentation Or Fraud is replaced by the following with respect to loss or damage caused by a Covered Cause of Loss other than fire: This policy is void if any insured, whether before or after a loss, has committed fraud or intentionally concealed or misrepresented any material factor circumstance concerning: a. This policy; b. The Covered Property; c. An insured's interest in the Covered Property; or M d. A claim under this policy. 5. The following paragraph is added and supersedes any provisions to the contrary: fl M. Nonrenewal 9. Subject to the provisions of Paragraphs 2. and 3. below, if we elect not to renew this policy, we will mail or deliver written notice stating the reason for nonrenewal to the first Named Insured shown in the Declarations and to the producer of record, at least 60 days, but not more than 120 days, before the expiration or anniversary date, We will mail or deliver our notice to the first Named Insured, and to the producer of record, at the mailing address shown in the policy. 2. Residential Property This provision applies to coverage on real property used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants'household property contained in a residential unit. If this Policy provides coverage as described in the preceding paragraph, and we elect not to renew this Policy, we will mail and deliver written notice, stating the reason for nonrenewal, to the first Named Insured shown in the Declarations, and to the producer of record, at the mailing address shown in the Policy, at least 75 days, but not more than 120 days, before the expiration or anniversary date. SB146916E (07-20) APPROVED Copyright,CNA All Rights ResLr By Cynthia Mora at 5:30 pm, Dec 02, 2024 SB146916E (Ed. 07-20) If we fail to give the first Named Insured shown in the Declarations notice of nonrenewal at least 75 days prior to policy expiration, as required in the paragraph above, this Policy, with no change in its terms and conditions, shall remain in effect for 75 days from the date that the notice of nonrenewal is delivered or mailed to the named insured. A notice to this effect shall be provided by us to the first Named Insured with the notice of nonrenewal. We may elect not to renew such coverage for any reason, except that we will not refuse to renew such coverage solely because: a. The first Named Insured has accepted an offer of earthquake coverage. However, the following applies only to insurers who are associate participating insurers as established by Cal. Ins. Code Section 10089.16. We may elect not to renew such coverage after the first Named Insured has accepted an offer of earthquake coverage, if one or more of the following reasons applies: (1) The nonrenewal is based on sound underwriting principles that relate to the coverages provided by this policy and that are consistent with the approved rating plan and related documents filed with the Department of Insurance as required by existing law; (2) The Commissioner of Insurance finds that the exposure to potential losses will threaten our solvency or place us in a hazardous condition. A hazardous condition includes, but is not limited to, a condition in which we make claims payments for losses resulting from an earthquake that occurred within the preceding two years and that required a reduction in policyholder surplus of at least 25%for payment of those claims; or (3) We have: (a) Lost or experienced a substantial reduction in the availability or scope of reinsurance coverage; or (b) Experienced a substantial increase in the premium charged for reinsurance coverage of our residential property insurance policies;and the Commissioner has approved a plan for the nonrenewals that is fair and equitable, and that is responsive to the changes in our reinsurance position. b. The first Named Insured has cancelled or did not renew a policy, issued by the California Earthquake Authority that included an earthquake policy premium surcharge. c. Corrosive soil conditions exist on the premises. If a state of emergency under California Law is declared and the residential property is located in any ZIP Code within or adjacent to the fire perimeter as determined by California Law, we will not nonrenew this Policy for one year, beginning from the date the state of emergency is declared, solely because the dwelling or other structure is located in an area in which a wildfire has occurred. However, we may nonrenew: a. If willful or grossly negligent acts or omissions by the named insured, or his or her representatives, are discovered that materially increase any of the risks insured against; or b. If losses unrelated to the post-disaster loss condition of the property have occurred that would collectively render the risk ineligible for renewal; or c. If there are physical changes in the property insured against, beyond the catastrophe damaged condition of the structures and surface landscape, which result in the property becoming uninsurable. 3. We are not required to send notice of nonrenewal in the following situations: a. If the transfer or renewal of a policy, without any changes in terms, conditions, or rates, is between us and a member of our insurance group. b. If the policy has been extended for 90 days or less, provided that notice has been given in accordance with Paragraph 1. SB146916E (07-20) Page 5 of 6 APPROVED Copyright,CNA All Rights Rese By Cynthia Mora at 5:30 pm, Dec 02, 2024 SB146916E (Ed. 07-20) c. If you have obtained replacement coverage, or if the first Named Insured has agreed, in writing, within 60 days of the termination of the policy,to obtain that coverage. d. If the policy is for a period of no more than 60 days and you are notified at the time of issuance that it will not be renewed. e. If the first Named Insured requests a change in the terms or conditions or risks covered by the policy within 60 days of the end of the policy period. f. If we have made a written offer to the first Named Insured, in accordance with the timeframes shown in Paragraph 1., to renew the policy under changed terms or conditions or at an increased premium rate, when the increase exceeds 25%. All other terms and conditions of the Policy remain unchanged. d m 'r 9 N 4 O N �Y APPROVED By Cynthia Mora at 5:30 pm, Dec 02, 2024 SB146916E (07-20) Page 6 of 6 Copyright,CNA All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description With respect to all employees subject to the workers' compensation laws of the state of California, any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. This policy is subject to a minimum charge of$250 for the issuance of waivers of subrogation APPROVED By Cynthia Mora at 5:30 pm, Dec 02, 2024 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.) This endorsement, effective 11/10/2024 at 12:01 AM standard time, forms a part of Policy No. EIG 4638195 04 Of the EMPLOYERS PREFERRED INS. CO. Carrier Code 00920 Issued to TRB AND ASSOCIATES Endorsement No. Premium $9,758 X'1_ Countersigned at on By: Authorized Representative WC 04 03 06 (Ed. 4-84) D 1998 by the workers'Compensation Insurance Rating Bureau of California.All rights reserved. CSGCONS-01NCHANNAPPA DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/24/2025 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). CONTACT License # 0C36861 Christine Spangler PRODUCER NAME: PHONEFAX Alliant Insurance Services, Inc. (628) 502-2841 (A/C, No, Ext):(A/C, No): 560 Mission St 6th Fl E-MAIL christine.spangler@alliant.com San Francisco, CA 94105 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Travelers Indemnity Company of Connecticut 25682 INSURER A : INSURED Travelers Property Casualty Company of America 25674 INSURER B : Pacific Insurance Company, Limited10046 INSURER C : CSG Consultants, Inc. 550 Pilgrim Drive INSURER D : Foster City, CA 94404 INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER: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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 300,000 CLAIMS-MADEOCCUR X 660-C130387912/10/202512/10/2026 $ PREMISES (Ea occurrence) X 5,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 X POLICYLOC PRODUCTS - COMP/OP AGG$ JECT OTHER:$ COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO 810-C130658112/10/202512/10/2026 BODILY INJURY (Per person)$ X OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ 5,000,000 B XX UMBRELLA LIABOCCUR EACH OCCURRENCE$ CUP-C139057712/10/202512/10/2026 5,000,000 EXCESS LIABCLAIMS-MADE AGGREGATE$ 0 X DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION B X STATUTEER AND EMPLOYERS' LIABILITY Y / N UB-C138878A12/10/202512/10/2026 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ Professional Liabili83OH0489503-2512/10/202512/10/2026 Ea Claim/Agg5,000,000 C DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory per general liability and automobile liability per attached endorsements. 30 Day Notice of Cancellation applies. Ejhjubmmz!tjhofe!cz! Uv!Usbo! Uv!Usbo!Ohvzfo! Ebuf;!3137/12/16! 21;54;31!.19(11( Ohvzfo CzUvUsboOhvzfobu21;53bn-Kbo16-3137 CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Planning and Building Agency 20 Civic Center Plaza, M-20 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD th\[L/— b a.9wʹ ЏЏЉΏ/ЊЌЉЌБАВ Policy Number: 660-C1303879 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION !Qpmjdz!Ovncfs;!771.D241498: Qpmjdz!Ovncfs!;!921.D2417692 Qpmjdz!Ovncfs!;!921.D2417692 ЊЋΉЊЉΉЋЉЋЎ