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178504 Servando Varela Dba Xv Solutions Certificate of Insurance Francine R. p'a.1,,1a a ,1r Page (1 of2) Villareal Iammmneemscae 7/7/2020 3:02:40 PM A� 7® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIVW 7/7/2020 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(s). PRODUCER On Tech Insurance UUNIAUI : NAME:00 ICINExt: (800) 668-7020 FAX, No: 877-826-9067 AN *as '��fechlnsurance E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 9 30 N. LaSalle, 25th Floor, Chicago, IL 60602 INSURERA: Sentinel Insurance Company, Limited 11000 INSURED INSURERS INSURER C Servan do Varela Dba Xv Solutions PO BOX 28373, Santa Ana, CA, 92799 INSURERD INSURERE: INSURERF: 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 INDICATED. NOTINITH STANDING 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF INSURANCE ADDL SUER VID POLICY NUMBER Y MMIDDVVV Y MMIDDVVV LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS -MADE IaIol OCCUR DAMAOF OR PREMISES Ea occurrence 1,000,000 $ MED FAR (Any one person) $ 10,000 PERSONAL & ADS INJURY $2,000,000 A Yes 46SBMUN0237 6/30/2020 6/30/2021 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 POLICY PROJECT [::] LOC ✓ PRODUCTS -COMP/OPAGG $ 4 000,000 $ OTHER AUTOMOBILE LIABILITY CO ME I NED S INGLE LIMIT Edaccident $ 2,000,000 BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS Yes 46SBMUN0237 6/302020 6/30/2021 BODILY INJURY (Per accident) $ A NON-OMED ✓ HIREDAUTOS ✓ AUTOS PROPERTYDAMAGE Pergood ent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ 1 $ WORKERS COMPENSATION AND EMPLOVERS'LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A E. L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below EL.DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Please see the attached "Additional Remarks Schedule" form for additional details and remarks CERTIFICATE HOLDER CANCELLATION City of Santa Ana 20 Civic Center Plaza, Santa Ana, CA 92701 Attn: Risk Management Division, 4th Floor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD IUBR Mari agalnent Diuisinn (R� EmEWED Is APPRcyvED By., ram. o_l llil _11-1�J-z' rAs6HlM�e ME44d ® Risk Management Analyst