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�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 11114I2D1E 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($). PRODUCER ADD Risk Services Northeast, Inc. Stamford CT Office CONTACT NAME: (NC No.Exp; (866) 283-7122 FAX No.): (800) 363-0105 EMAIL ADDRESS: 1600 Summer Street Stamford CT 06907-4907 USA INSURER(S) AFFORDING COVERAGE NAIL# INSURED INSURERA: Liberty Mutual Fire Ins Co 23035 SCST, LLC 6280 Riverdale Street INSURER B: INSURER C: San Diego CA 92120 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570073902407 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR aUPR TYPE OF INSURANCE INSD MD POLICY NUMBER MMIDDIYYYY MMIDDPNY LIMITS X COMMERCIAL GENERAL LIABILITY TB Z B H EACH OCCURRENCE $1,000,000 CLAIMSMADE ❑X OCCUR PREMISES Ea occurrence $100,000 MED EXP (Any one person) $5, 000 PERSONAL S ADV INJURY $1.000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $2,000,000 POLICY PRO ❑X LOG JECT PRODUCTS-COMPIOPAGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY AS2 Zll-67J86H-018 03/01/201803/01/2019 COMBINED SINGLE LIMIT Ea accident g1, 000,000 BODILY INJURY (Per person) X ANYAUTO BODILYINJURY(Per acad.rh OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Pewr.aAkdent ccid UMBRELLALIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS -MADE DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR I PARTNER I EXECUTIVE FN OFFICE "MEMBER EXCLUDED? N (Mandatory in NH) NIA WC2Z11B7186H048 03 01/2018 03 01/2019 PER OTH- X STATUTE E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe undo, DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000, 000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, it's officers, employees, agents, and representative are included as Additional Insured in accordance with the policy provisions of the General Liability policy. If the General Liability, Auto Liability or Workers' Compensation policies are cancelled for any reason, other than nonpayment, notification will be sent to the organizations or persons per the schedule on file with the company. Notice Will be sent 30 days before cancellation becomes effective in accordance with the policy provisions. Failure to provide notification of a pending cancellation will not extend the policy cancellation date nor negate policy cancellation. G CERTIFICATE HOLDER CANCELLATION mq SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana AUTHORIZED REPRESENTATIVE Attn: Purchasing Division 20 Civic Center Plaza Santa Ana CA 92701 USA ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD 57