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SCOTFAZ-01
<br />MCGRAWM
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE 0
<br />5118/218/2020
<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 />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsemen s).
<br />PRODUCER License # OE67768
<br />C,0AT CT All Smith
<br />IOA Insurance Services
<br />4370 La Jolla Village Drive
<br />Suite 600
<br />PHONE
<br />(AIc, Ne, Eat): (619) 788-5795 50206 (a/c, No :(619) 574.6288
<br />AbmA�'Lss. Ali.Smith@ioausa.com
<br />San Diego, CA 92122
<br />INSURER s AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A:RLlInsurance Company
<br />13056
<br />INSURED
<br />INSURER B: Continental CasualtyCompany
<br />20443
<br />INSURER C:
<br />Scott FaZekas & Associates, Inc.
<br />INSURER D :
<br />17777 Del Paso Drive
<br />Poway, CA 92064
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER- 1
<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 />INSR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBINSO IZ
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXPLTR
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERALLIABILITY
<br />CLAIMS -MADE X OCCUR
<br />Cent LiablSev of Int
<br />)t
<br />PSB0003027
<br />615/2020
<br />6/5/2021
<br />EACH OCCURRENCE
<br />g 1,000,000
<br />DAMAGE TO RENTED
<br />REMISES Ea occu e
<br />1000000
<br />X
<br />MED EXP An onecareen)
<br />10,000
<br />PERSONAL S ADV INJURY
<br />11000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY JELQT T LOC
<br />GENERALAGGREGATE
<br />2,000,000
<br />PRODUCTS -COMWOPAGG
<br />2,000,000
<br />Deductible
<br />0
<br />OTHER:
<br />APUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />a accidentl
<br />1,000,000
<br />BODILY INJURY Per person)$
<br />ANY AUTO
<br />AUTOSONLYSCHEDULED
<br />SSWULED
<br />PSB0003027
<br />615/2020
<br />61512021
<br />BODILY INJURY Peraccident
<br />$
<br />M03 I AMAGE
<br />$
<br />AOTOS ONLY X AUTOS ONLY
<br />Aot so. Owned
<br />Deductible
<br />p
<br />A
<br />X
<br />UMBRELLA LIAR
<br />X
<br />OCCUR
<br />EACHOCCURRENCE
<br />$ 2,000,000
<br />AGGREGATE
<br />$ 2,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />PSE0001119
<br />61512020
<br />61512021
<br />DED I X I RETENTION$ 0
<br />A
<br />WORKERS COMPENSATION
<br />ANDEMPLOVERS'LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE ❑
<br />(Mantlamry EMBEREXCLUDED?
<br />H yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />P$W0001945
<br />6/5/2020
<br />615@021
<br />X PER OTH-
<br />ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE -EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE- POLICY LIMIT
<br />1,000,000
<br />B
<br />Professional Liab.
<br />MCH288352513
<br />6/5/2020
<br />61512021
<br />Per Claim
<br />1,000,000
<br />B
<br />Ded.: $20k Per Claim
<br />MCH288352513
<br />6/5/2020
<br />6/512021
<br />Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />Re: All Operations
<br />City of Santa Ana, Its officers, employees, volunteers, representatives and agents are Additional Insureds with respect to General Liability per the attached
<br />endorsement as required by written contract.
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions..
<br />REVIEWED & APPROVED
<br />y, 0
<br />City of Santa Ana
<br />Attn: Risk Management Divison
<br />20 Civic Center Plaza, 4th Floor
<br />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 />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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