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A`� id CERTIFICATE OF LIABILITY INSURANCE <br />I2nuzozo <br />ATE <br />D4/14/ 020 Y) <br />4/14/2020 <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 endorsements . <br />PRODUCER Lockton Insurance Brokers, LLC <br />777 S. Figueroa Street, 52nd FI. <br />ONTACT <br />CNAME <br />PHONE FAX r <br />CA License f10F15767 <br />Los Angeles CA 90017 <br />(213) 689-0065 <br />E-MAIL�O <br />ADD <br />INSURERS AFFORDING COVERAGE <br />NAIC S <br />INSURER A: Crinn & Forster Specialty Insurance Co <br />44520 <br />" D Rincon Consultants, Inc. <br />1462718 180 N. Ashwood Ave. <br />vauxuaI a: Hartford Fire Insurance Company <br />19682 <br />INsuRER c : Starstone National Insurance Company <br />25496 <br />INSUREIRD ; <br />Ventura CA 93003 <br />INSURER E : <br />INSURER F : <br />COVERAGES RINC001 CERTIFICATE NUMBER: 16059509 REVISION NUMBER: XXXXXXX <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 />YMR <br />TYPE OF INSURANCE <br />ADDL <br />SUER• <br />POLICY NUMBER <br />POLICY EFF <br />POLICY E%P <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLNMS4tADE FRI OCCUR Z <br />Y <br />Y <br />EPK-125280 <br />12/17/2018 <br />12/17/2020 <br />/ <br />EACH OCCURRENCE <br />f 3.000.000 <br />PREMISES E. oo,unenc,A <br />f 100,000 <br />X <br />MED EXP (Any one Person) <br />f 10,000 <br />SIR: $50,000 <br />/ <br />✓ <br />! <br />X <br />P&I <br />PERSONAL A ADV INJURY <br />f 3 000 000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE <br />f 4,000,000 <br />POLICY JPERP LOD <br />PRODUCTS -COMPAJP AGO <br />f 4000000 <br />It <br />OTHER. <br />B <br />AUTOMOBILE <br />LIABILITY <br />Y <br />y <br />72WNCB52$8 <br />2/1202D <br />2/12D21 <br />COMBINED SINGLE LIMB <br />Es ecdEent <br />f 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />It YV_VV(?(X}( <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />/ <br />I <br />BODILY INJURY (Per accident) <br />f XXXXXJIX <br />X <br />PROPERTY DAMAGE <br />P <br />$ XXXXXXX <br />HIRED NON -OWNED <br />AUTOS ONLY X AUTOS ONLY <br />sXXXXXXX <br />A <br />UMBRELLA LUB <br />OCCUR <br />N <br />N <br />EFX-114134 <br />12/172019 <br />12/17/2020 <br />EACH OCCURRENCE <br />f 5000000 <br />X <br />AGGREGATE <br />f 5,000,000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED X RETENTIONS 10000 <br />1 E <br />C <br />WORKERS COMPENSATION <br />Me EMPLOYERS' LIABILITY YIN <br />ANV PROPRIETORPARTNERIEXEC <br />OFFICEWEMBER EXCLUDEDi <br />(Mandatory In NH) <br />N/A <br />Y <br />T10200329 <br />2/12020 <br />Z/12021 <br />PER OTH- <br />%{STATUTE ER <br />EL. EACH ACCIDENT <br />It 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />It ] 000 000 <br />K yas desoribe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />E 1,000,000 <br />A <br />Contractors Pollution Liab <br />N <br />N <br />EPK-125280 <br />12/172018 <br />12/172020 <br />Limit: $3,000,000/$4,000,000 A/ <br />E&O Liab: Claims Made ✓ <br />Limit $3,000,000454,000,000 -! <br />DESCRIP1gN OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may M eMeMel N mon span is "Wed) <br />THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DiviSION <br />AP 4 2020 <br />16059509 <br />City of Santa Ana <br />Risk Management Divison <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 <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 <br />n <br />All riahtR reserved. <br />ACORD 25 (2016103) <br />The ACORD name and logo are registered marks of ACORD <br />