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�vRb� CERTIFICATE OF LIABILITY INSURANCE <br />DATEIMWODNYYY) <br />1211612019 <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(les) 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 ileu of such endorsement(s). <br />PRODUCER <br />RCONTACT <br />Hiscox Inc. dlb/a/ Hiscox Insurance Agency In CA <br />PHONE T FAx <br />202�_.300_ <br />) <br />520 Madison Avenue <br />-EIIAILP .EXU.. _(88g .___INC, No): <br />eontac(@hlscox.com <br />32nd Floor <br />.ADDRESS _ <br />New York, NY 10022 <br />INSURERIS)AFFORDING COVERAGE NAICp <br />INSURERA: Hiscox Insurance Company Inc <br />_ <br />10200 <br />Steiman Enterprises, LLC <br />INsuaersp��_�__,_ <br />_ <br />207 North Broadway - Suite S6 8112 <br />SANTA ANA. CA 92701 <br />JNSURER D: <br />INSURER E:�_�__e_____________�.._ <br />INSURER F <br />COVERAGES CERTIPICATF NLJMRFR- dcvfetnM AUltUMME, <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 WI410H 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 />TVA <br />TYPE OF INSURANCE <br />A LSUBR <br />PGLICYNUMSER <br />MO_70EFY <br />PMIDDmVY <br />_ _ <br />�— LIMITS <br />X _. <br />COMMERCIAL GENERAL LIABILITY <br />_ <br />EACHOCCURRENCE <br />S 1,000,000 <br />LX <br />BATAAGEfiO-RcNTEp <br />— <br />OLAIfASMAOE OCCUR <br />PREMISES IEa ocgl(renco)_ <br />S_100,000 <br />s5,000 <br />PERSGNALaADVw3URv <br />_ <br />$ 1,OOQ000 _ <br />Y <br />UDC-1367518•CGL-19 <br />07124/2019 <br />07124/2020 <br />AGGREGATE LIMIT APPLIES PER: <br />GEN'L <br />GENERAL AGGREGATE <br />If 2.000,000 <br />X <br />POLICY C] PRO L_l <br />ECT LOC <br />PROUlICT3-COMPobPAGO <br />$SIT Gen. A <br />�g____. <br />OTHER: <br />$ <br />AUTOMODRALNABILITY <br />COMBINED SINGLE LIMIT <br />$ <br />v id. u_ <br />��.._ <br />ANY AUTO <br />BODILY INJURY IPe poison) <br />$ <br />._ <br />OWNED - --- <br />SCHEDULED <br />AUTOS ONLY AUTOS <br />�'� <br />BODILY INJURY (Pei eccldoni) <br />S <br />HIRED I NLY <br />PROPERTY OAMA(TaE <br />AUTOS ONLY _.j AUTOS ONLY <br />AUTOS <br />IPu aaMe ql _^� <br />g <br />UMBRELLA LIAR <br />-_ � <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXGES I LIAR <br />DIAIMS•MADE <br />AGGREGATE <br />—. <br />DED I RETENTIONS <br />_ ....___..... _._. <br />_S_. ._._._.___..._._._ <br />WORKERS COMPENSATION <br />PER TH- <br />ANDEMPLOYEnS'LIABILITY YIN <br />_ TATUTE ER <br />ANYPROPRIETORIPARTNE W EXECUTIVE <br />E.L.EACH ACCIDENT_ <br />OFFICCRIMEMBEREXCLUDE07 <br />(Mandatory In NN) <br />NIA <br />E.L. EAEMPLOYEE <br />$ <br />If ySCRIPTION ftwlib. antler <br />�— <br />DESCRIPTIONun OPERATIONS below <br />E.I.. DISEASE, POLICY LIMIT <br />0 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Romulis Sehodulo, may bo AtMehad d more spaeo Is rec onom <br />Tile City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents and volunteers are namedas additional insureds ("additional inSuredV*) w <br />till regard to liability and defense of suits adsing from the operations and uses performed by or on behalf of the named insured. <br />CERTIFICATE HOLDER CANCELLATION <br />The City of Same Ana <br />20 Civic. Center Plaza Santa Ana, California <br />1 EVI <br />ED & APPR <br />SHOULD ABOVE DESCRIBEDPOLICIES <br />CBE CELLED <br />I3yRI. <br />MANAGEMENTDIVI510 <br />THE EXPIRATION DATE NOTICE WILLL DELIVEREDORE <br />IN <br />ACCORDANCE <br />WITH THE POLICY PROVISIONS. <br />C20 2019 <br />AUTHORIZEDREPRESENTATIVE <br />e 1980.2016 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />