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AC-4;�;i'' CERTIFICATE OF LIABILITY INSURANCE � DATE(MM/DD/YYYY) 1 nm9nnl G 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(les) must be endorsed. If SUBROGATIONIS 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 hostler in lieu of such endorsement(s). PRODUCER CONTACT NUTMEG INS AGENCY INCIPHS 78210781 The Hartford Business Service Center NAME, PHONE (888) 925-3137 INC, No, Eaq: FAX (888) 443-6112 (Arc, No): 3600 Wiseman Blvd E-MAIL San Antonio, TX 78265 ADDRESS: INSURER(S) AFFORDING COVERAGE NAICX INSURED INSURERA: Sentinel Insurance Company Ltd. 11000 ELISA STIPKOVICH INSURER B: 500 HIGH DR INSURERC: LAGUNA BEACH CA 92651-1525 INSURER D: INSURER E: INSURER F I COVERAGES CERTIFICATE NUMBER: 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 INOICATED.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. INSF TYPE OF INSURANCE ADDL S BR POLICY NUMBER POOCYEFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE[flOCCUR General Liability ty X DAMAGE TO RENLED PREMISES a er rcel $1,000,000 MED EXP (Any meperean) $10,000 A X 76 SBU BC5868 08/14/2019 08/1412020 I PERSONALAADVINJURY $1.000,000 GENL AGGREGATE UNIT APPLIES PER: GENERAL AGGREGATE $2.000,000 POLICY ❑ PRO- E] LOC JECT PRODUCTS-COMP/OPAGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT fFeamiftall $1,000,000 ANY AUTO BODILY INJURY (Par Parson) A ALL OWNED SCHEDULED AUTOS AUTOS 76 SBU BC5868 08/14/201g 08/1412020 60DILY INJURY(Perac dent) X HIRED NON-0yVNEO AUTOS X AUTOS PROPERTY DAMAGE (Per accident) UMBRELLA UAB OCCUR EACH OCCURRENCE EXCESS UAB CLAIMS. MADE AGGREGATE RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY TATUTE I ER E.L EACH ACCIDENT ANY YIN PROPRIETOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA EL DISEASE -EA EMPLOYEE (Mandatory In NH) 11 yea, desalbe under E L DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS A IDATA BREACH - BUS INC & EX 76 SBU BC5868 08114/2019 08/14/2020 Limit$10,000 EX DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Rwaft w.dule, may be ahachad Wrnme space H required) Those usual to the Insured's Operations. CITY OF SANTA ANA is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. UIIY UI-SAN IA ANA By Risk MANAGEMENT DivisioN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 20 CIVIC CENTER PLZ BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED SANTA ANA CA 92701-4058 IN ACCORDANCE WITH THE POLICY PROVISIONS. T03 2019 AUTHORED REPRESENTATIVE weana- Ctrafizi c� no 1nAA.90d5 ACrTRD cnlxanwerinu eu .L.ta�.m�e..,va ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD