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OP ID: YC <br />,a►�oRflW CERTIFICATE OF LIABILITY INSURANCE <br />DAT61221219 019 <br />05/221 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsements . <br />PRODUCER <br />Narver Associates Ins Agcy <br />P,O. BOX 1509 <br />San Gabriel, CA 91778.1609 <br />WESLEY HAMPTON HOUSE <br />CONTACT June Samarin <br />PHONE 626-943.2237 FAX <br />AIC No Ext: Nc,No: 686-299-1010 <br />E-MAIL s: lSan nE-narver.com <br />PRODUCER <br />CUSTOMER ID N: LIEB1 <br />INSURER(S) AFFORDING COVERAGE <br />NAICM <br />INSURED Liebert Cassidy Whitmore <br />INSURER A: Sentinel Insurance Company <br />11000 <br />6033 W. Century Blvd. Sth Fir <br />Los Angeles, CA 90046 <br />INSURER B: Federal Insurance <br />12890 <br />INSURERC:Aspen Specialty Insurance <br />10717 <br />INSURER D: Lloyds of London <br />15792 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER' <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />INBR <br />MIL <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDDIVYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 2,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X❑ OCCUR <br />X <br />72SBAAK0318 <br />12/14/2018 <br />12/14/2019 <br />ET RENT <br />PREMISES Eaoccurrence <br />$ 1,000,000 <br />MED EXP (Any one parson) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPIOP AGO <br />$ 4,000,000 <br />X POLICY PRO-IECT LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 2,000,000 <br />ANY AUTO <br />BODILY INJURY (Per person) <br />$ <br />-- <br />ALL OWNED AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />A <br />X <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />72SBAAK0318 <br />12114/2018 <br />12/14/2019 <br />PROPERTY DAMAGE <br />(PER ACCIDENT) <br />$ <br />A <br />X <br />NON-OWNEDAUTOS <br />72SBAAK0318 <br />12114/2018 <br />12/14/2019 <br />s <br />S <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />S 4,000,000 <br />AGGREGATE <br />- <br />$ 4,000,000 <br />A <br />EXCESS LIAB <br />CLAIMS -MADE <br />72SBAAK0318 <br />12114/2018 <br />12/14/2019 <br />DEDUCTIBLE <br />$ <br />$ <br />X <br />RETENTION $ 10,000 <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFF IC MEMBER EXCLUDED9 ❑ <br />(MandatoryinNH) <br />f yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />7175.05.95 <br />04/0112019 <br />04/01/2020 <br />X C STATU- OTH- <br />TOR L M T ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />-- <br />$ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />$ 1,000,00 <br />C <br />Professional Liab. <br />LRA9AF817 <br />12/10/2018 <br />12/10/2019 <br />Per Claim 5,000,00 <br />D <br />Cyber Liability <br />WN163087 <br />12/06/2018 <br />12/06/2019 <br />Per Claim 3,000,00 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />Certificate Holder is named as an Additional Insured in regards to attached <br />General Liability Form SS 00 08, per written contract or agreement. <br />CERTIFICATE HOLDER CANCELLATION <br />CITYSAA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Cityof Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />P.O. Box 1988 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />© 1988.2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD <br />