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Client*- $134176 <br />PTF-VA iF13:A Ti <br />ACORD, CERTIFICATE OF LIABILITY INSURANCE <br />DATE(M1/1512020 YY) <br />020 <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 have ADDITIONAL INSURED provisions or be endorsed. <br />ff SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />USI Insurance Services LLC <br />Lic III OG11911 <br />7535Irvine Center Dr. Suite 250 <br />Irvine, CA 92618 <br />CONTA <br />Ray Thrall <br />PHONE 949-790-9423 <br />A/C, No, Extf: k N J: <br />ADDRESS: raymond-thrall@usi.com <br />INSURER(s)AFFORDING COVERAGE <br />NAIL: <br />. INSURER A : NwPmeY' Inw,wm allmce or w <br />36664 <br />INSURED <br />W aymakers <br />1221 E. Dyer Rd., Suite 120 <br />Santa Ana, CA 92705-5700 <br />INSURER B : ueery Maw Rry mw,w" camwnv <br />23035 <br />NSURERC: <br />INSURER D: <br />INSURER E: <br />_ <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 CONTRACTOR 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 />LTADDLSR <br />TYPE OF SISURANCE <br />USR <br />POLICY NUMBER <br />MWO POLICYNYYYI EFF <br />POLICY <br />LIMITS <br />A <br />X <br />cOMMERcIM-GENERALLIABILITY <br />CLAIMS -MADE ❑X OCCUR <br />Sexual Abuse $1 m/$1 M <br />X <br />X <br />201912069NP0 <br />NIL Deductible <br />101011201910101/202 <br />EACH OCCURRENCE <br />S1000000 _ <br />$500 000 _ <br />s20000 <br />s1000000 <br />s3000,000 <br />s3000000 <br />� i� E,°mn„1 <br />X <br />MEDEXP(MNrrepenon) <br />X <br />Professional$1Ml53M <br />PERSONAL aADVINJURY <br />GENL AGGREGATE LIMIT APPLIES PER: <br />POLICY JJEECOT FKLOC <br />OTHER: <br />GENERAL AGGREGATE <br />PRODUCTS-COMPIOPAGG <br />$ <br />A <br />OMOBILE LIABILITY <br />ANY AUTO <br />U NOES ONLY AUTOS <br />AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY X AUTOS ONLY <br />X <br />201912069NP0 <br />$500 COMP Ded. <br />$500 $500 COLL Ded. <br />0101/201910/01/202 <br />COMBINED SINGLE LIMIT <br />odenl <br />1,000,000 <br />X <br />X <br />BODILY INJURY (Per panm) <br />S <br />BODILY INJURY (Pr ap I) <br />S <br />s _ <br />S <br />PROPERTY DAMAGE <br />PrspcKI.,n <br />A <br />X <br />UMBRELLAUAS <br />IXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />X <br />201912069UMBNPO <br />0/01/201910/01/202 <br />EACH OCCURRENCE <br />$10000000 <br />$10 000 000 <br />AGGREGATE <br />DED X RETEWIONSS10000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYEW L ABILnY <br />ANY PROPRIETORIPARTNERIE(ECUTIVEY/N <br />OFFICERIMEMBER EXCLUDED] <br />(Msnda" In NH) <br />OESCRIIP`nON OF OPERATIONS tnlow <br />NIA <br />X <br />WC2641443907029 <br />1010112019 <br />W01/2020 <br />X MUTE OTH- <br />E.L. EACH ACCIDENT <br />S1000000 <br />E.L. DISEASE- EA EMPLOYEE <br />$1 00O 000 <br />E.L. DISEASE -POLICY LIMIT <br />S1,000000 <br />A <br />Fiduciary <br />201912069NP0 <br />1010112019 <br />10101/2020 <br />$1,000,000 Limit <br />NIL Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may Ise atbphed N mon spats Is reaulm) <br />RE: Santa Ana Family Justice Center, 60 Civic Center Plaza, Santa Ana, CA 92701. Santa Ana Justice Center <br />VAP. The City, its officers and employees are named as additional insured's. <br />REVIEWED d _dUAPPROVED <br />City of Santa Ana <br />Risk Management Div <br />20 Civic Center Plaza, <br />Santa Ana, CA 92701 <br />17 2020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />l M. LAMBERT <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2015 ACORD CORPORATION. All rights reserved <br />ACORD 25 (2016103) 1 Of 1 <br />#S27708470IM26791413 <br />The ACORD name and logo are registered marks of ACORD <br />RGTJG <br />