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Client#: 1778682 CBGENERHOL ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 01/28/2020 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(les) 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 any rights to the certificate holder In lieu of such endoreement(s). PRODUCER REACT - - USI Insurance Services LLC p PHD No EM:513 852.6300 a ac xa : 513 852.6426 312 Elm Street, 24th Floor .MAIL Cincinnati, OH 45202 ADDRESS: 513852$300 INSURERIS) AFFORDING COVERAGE NAIC0 INSURER A: ODEm.a,.,weenondiso 39217 _ INSURED 311s, LLC INSURER B:Pn 0O "In•u,anmwwny 37267 INSURERC: 0-1Assni.=Eaelwumn cw�wnr 37532 1 340 Russell Cave Road INSURER D: Lexington, KY 40505 INSURER E : INSURER F: :EH THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LTR TYPE OF INSURANCE DR UB POLICYNUMSER MM/DDY� MM/DD EXP UNITS A X COMMERCIAL GENERALUABILITY CLAIMS -MADE OCCUR CGA1331044 3101/2019 031011202C EACH S1 000000 ��OCCURRENCE MREMHqISE ESENTTEEIDa�e S1 OOO 000 MEDEXP(Anyone ) $10000 PERSONAL S ADV INJURY S1 D00000 AGGREGATE LIMIT APPLIES PER. PROJECT �LOC POLICYa GENERALAGGREGATE 52000,000 GENL PRODUCTS s2000000 $ OTHER: A AUTOMOBILE X X LIABILITY ANY AUTO OWNED SCHEDULED NLY A AUTOS OUTOS AUTOS ONLY X AUTOS ONLY CBA1331044 0310112019 0310112020 COMBINED SINGLE LIMIT Ea acddenO S1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per acddenD S PPer aw'PERTY DAMAGEM O S S A X UMBRELLA WIB LX—J OCCUR CCU1331044 0310112019 0310112020 EACH OCCURRENCE s25.000.000 EXCESS LAG CLAIMS -MADE AGGREGATE s26,000,000 DED I X RETENTION$10000 S B WORKERSCOMPENSATION AND EMPLOVERS'LIABILITYY I N ANY PROPRIETOR/ EXCLUDED? OFFICER/MEMBER EXCLUDEDi � NIA CWC31044 0310112019 03/01/202 X PER oTH- E.L. EACH ACCIDENT 51 000 000 E.L. DISEASE EA EMPLOYEE $1000000 (Mandatory In NH) Il yyeeadeaulcer DESG�RIPTIONTION OF OPERATIONS Eelox E.L. DISEASE- POLICY UMIT 51000000 C Pollution PREE29196800 0113112018 01/31/2021 $3,000,000limit Liability DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 1e1, Additional Remarks Schedule, may bs attached It more space is required) RE: RFP 19.104 The General Liability and Automobile Liability policies Includes an automatic Additional Insured endorsement that provides Additional Insured status to City of Santa Ana, its officers, employees, agents and representatives, only when there Is a written contract that requires such status, and only with regard to work performed on behalf of the named Insured. The General Liability policy contains a special (See Attached Descriptions) 3y F1 City of Santa Ana Risk Management Division 20 Civic Center Plaza 4th F Santa Ana, CA 92701--- - 1V1A"l1GFIIFNi nIViSFCNI SHOULDANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLEDBEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 'G(j.J1 R��nryn ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (:f1RPr1RAT1l1M ell .L.L,e ...e.......w ACORD 25 (2016103) 1 of 2 The ACORD name and logo are registered marks of ACORD #S27792817/M27024123 JLCA2