SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
E-MAIL
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
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. $ $
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
10/30/2025
McGriff Insurance Services LLC
9850 NW 41st Street
Suite 100
Doral FL 33178
Lauren Mayer
954-385-6022
866-802-8684
[email protected]
Berkshire Hathaway Homestate Ins Co
20044
132SAFEBLLC
Everest Indemnity Insurance Company
10851
Interwest Consulting Group, Inc.
444 N Cleveland Ave;
Loveland CO 80538
Bridgeway Insurance Company
12489
Lexington Insurance Company
19437
Great American E&S Insurance Company
37532
1935727376
B
X
1,000,000
X
300,000
X
10,000
10,000
1,000,000
2,000,000
X
X
Y
Y
CF3GL00415251
10/3/2025
10/3/2026
2,000,000
B
1,000,000
X
X
X
Y
Y
CF3CA00337251
10/3/2025
10/3/2026
Excess per occ / agg
1,000,000
C
D
X
10,000,000
X
Y
8EA7XL000207904
11170903
10/3/2025
10/3/2025
Y
10/3/2026
10/3/2026
10,000,000
X
-0-
A
X
N
Y
SAWC666825
5/12/2025
5/12/2026
1,000,000
1,000,000
1,000,000
E
Professional Liability
TER5780118
10/3/2025
10/3/2026
Each Claim/Aggregate
$10,000,000
Excess policy # 140002058 effective 10/03/2025 -10/03/2026 - QBE Ins Corp NAIC #39217 - Limits- $5,000,000 part of $10,000,000 Excess of $5,000,000.
Crime coverage – Federal Insurance Company, NAIC 20281- Policy #J06767825 effective 10/3/25 -10/3/26; Limit $1,000,000 DED $10,000. Technology Errors & Omissions and Cyber Coverage - Allied World Assurance Company US, Inc. NAIC # 19489 - Policy #03148733 effective 10/3/25 - 10/3/26. Each Claim/AGG $3,000,000 DED $100,000.
City of Huntington Beach Public Works Department is named as additional insured with respects to general liability, with a written contract. Blanket coverage appliesfor the general liability coverage. Waiver of subrogation applies for general liability and workers compensation in favor of the Certificate Holder, with a written contract.
City of Huntington Beach
Public Works Department
Attn: Joe Pinel
2000 Main Street
Huntington Beach CA 92648