ACORD® CERTIFICATE OF LIABILITY INSURANCE
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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
MPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. I UBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on thi certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
NAMEACT
Aon Risk Services Central, Inc.
Pittsburgh PA office PAC.N. EX: (866) 283-7122 .: 800) 363-0105 EQT Plaza ~ Suite 2700 SOBESS:
625 Liberty Avenue
Pittsburgh PA 15222-3110 USA
INSURERS) AFFORDING COVERAGE NAIC #
INSURED INSURER A: erican Guarantee & Liability Ins 26247 Michael Baker International, Inc INSURER B: Tied World Surplus Lines Insurance 24319 5 Hutton Centre Drive zurich American Ins co
Suite INSURER C: 16535
500
Santa Ana CA 92707 USA
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 570094918568 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 Limits shown are as requested
TYPE OF INSURANCE POLICY NUMBER LIMITS
X| COMMERCIAL GENERAL LIABILITY GL0419728101 08/30/202208/30/2023 EACH OCCURRENCE 51,000,000 DAMAGE TO RENTED $1,000,000
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence)
MED EXP (Any one person) $10,000
PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 1 PRO-
POLICY X JECT [X]Loc PRODUCTS- COMPIOPAGG $2,000,000
OTHER: SIR/Deductible $250,000
AUTOMOBILE LIABILITY BАP4197284-01 108/30/222.08/30/2023 Can SINGLE LIMIT $1,000,000 X ANY AUTO ODILY INJURY (Per persor
OWNED → SCHEDULED ODILY INJURY (Per accidon
AUTOS PROPERTY DAMAGE
T NON-OWN:
UTOS ON (oracciden)
$100,000
X UMBRELLA LIAB OCCUR AUC053258204 108/30/2022 08/30/2023 EACH OCCURRENCE 510, 000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10, 000,000
/DED | X ]RETENTION 520,000
WORKERS COMPENSATION AND WC419728201 108730/20220873072023 x PERSTATUTE eTH:
EMPLOYERS' LIABILITY AOS
N NIL WC419728501 08/30/2022/08/30/2023_EL. EACHACCIDENT $1,000,000 (Mandatory In NH) WI E.L. DISEASE-EA EMPLOYEE $1,000,000 YES ATON OF OPERATIONS belaw E.L. DISEASE-POLICY LIMIT $1,000,000 E&O-PL-Primary 03124806 08/30/2022 08/30/2023 per claim $1,000,000 Aggregate $5,000,000
Sia a lads per policy terns & conditions
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Addlional Remarks Schedulo, may be allached if more space is required) Svcs., MB Project No.
By:.
MICHAEL E GATES
CERTIFICATE HOLDER CANCELLATION CITY ATTORNEY
SHOULD ANY OF THE ABOVE DESCRIBE POLISHENTANGED BE BELA CH
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
ity of Huntington Beac AUTHORIZED REPRESENTATIVE
000 Main Stree
Huntington Beach CA 92648-2702 USA
Non Rich Sorries Central Pra
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