NATIONAL DATA AND SURVEYING SERVICES, INC.

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CERTIFICATE OF LIABILITY INSURANCE OATE(MMIDOIYYYY) 9/23/2019 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 pollcy(les) 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 Hunts to the certificate holder In lieu of such ondorsement s . PRODUCER tlVN AC. Yehuda Kaplan ROSEWOOD RISK MGMT & INS SOLUTIONS 7162 Beverly Blvd, Ste 180 LOB Angeles, CA 90036 nnoM> 323 899-3081 "" e,{816) 895-9169 �ILm y ap an rrmis cam -- —� License#:OH38577 INSURER AFFORDING COVERAGE INSURFRA Insurance Company NAICP 10673 INSURED National Data and Surveying Services INSURERBI US Fire Ins. Co. 1113 1535 S La Cienega Blvd INSURORQ, StarStone National Insurance Cc 254 66 Los Angeles, CA 90035 INSURCRD:4BE Insurance Cc 392 7 (323) 782-0090 Company ,Penn-Amer.lea Insurance COVF_RAGES CERTIFICATE IJUNIHER� _ RFVISON 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. N07WITI'ISTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT ID 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.. LIMI rS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, A TYPE OF INSURANCE I c r) -NPR POLICY E I POLICYYYYv LIMITS $ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000 000 CLAIMS -MADE ® OCCUR , 100, 000 McDF P A"°°°" "`"°" CPV0029824 9/17/19 9/17 /20 g -- 5000 - A F Y Y PERSONALNAOV INJURV �^^^-�------ PAV0201504 $ 1J 000�000 33HN'LAGORS�i�tiTGLIMII`APPLIES PER: pENF.RAL AGGREGATE $ 2, 000r000 POLICY I.X JECOT ®LOC PRODUCTS-COMPIOPAGG InClUded _ .w Deductible $ 2,500 AUrOMDBILELIABILITY jltrtU�INEO SWQI,E L! fl "t $ g ANYAUTO BODILY INJURY IPPr person) USF 133-746231-6 9/17/199/17/20 $ OWNED BCHEDULED BODILY INJLIRY(Par acaid-10 B AUTOS ONLY AUTOS y y $ HIRED NON -OWNED '9'rY DAMAGE x. R $ AUTOB ONLV AUTOS ONLY UMBRELLA LIAR $ OCCUR EACH OCCURRENCE $ 5,000,000 [' �( E%CEBS LIAR CLAIMS-MAOE Y Y AGGREGATE 77763H196ALI 9/17/199/17/20 —• X gg,TFNun3i10L000 WORKERS COMPENSATION X PER Ole EMPLOYERVUABILITY -111 .--. 9/17/199/17/20 .. ANY PROPRIETORIPARTNERIE%ECUTIVE P0014-CE191653604C E.I EACH ACCIDF_Nr $ ir000r000 D OrrICCRIMEMBrR EXCWDED7 NIA Y (Mar,Mcry h NH) F„( DISEASE -EA EMPLOYEE $ r r 6 roa.aannlbo urldw - •Y e" 9" N4 _ 1, 000� 000 PN'RI T! nP u,l �� E P9LI r DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addlllonal Romarks Schadds may Ire ellaehadil more spas a le required) City of Santa Ana its officers, employees, agents and representatives are provided additional insured status on a primary and noncontributory basis as required by written contract or agreement. A Waiver of Subrogation is in favor of the additional insured. 30 Days Notice of Cancellation, 10 Days for Non Payment of Premium. Risk Management Division 4th Floor SHOULD ANY OF THE ABOVE DESCRIBFD POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEIJVERED IN ACCORDANCE W ITH T'HE POLICY PROVISIONS. Santa Ana, CA 92702 REVIEWED & APPROVED AUTHORIZED REPRESENTATIVE By disk MANACEMENT DivisivN 21 ((�} if(�$ © 1988-2015 ACORD CORPORATION. All rights reserved, ACORD 25 (2016/03) t"f ,f?�il laEid I pare registered marks of ACORD FRANCINE R, VILLAREAL