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Digit lly signed Tori irson Tori Pierson Datea2021.10.112b15:43:13e0700' D/Y1 ACOR" CERTIFICATE OF LIABILITY INSURANCE DAT0105/ 1 0l0572021 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(ies) 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONAME:NTA Fred Dabiri Independent Group Agency PHONE (818) 380-1391 FAX (818) 290-7497 A!C No Ext : (AIC No): 21700 Oxnard Street E-MAIL fdabiri@igainsurance.com ADDRESS' Suite 1045 INSURER(S) AFFORDING COVERAGE NAIC Id Woodland Hills, CA 91367 INSURER A : Sentinel Insurance Company INSURED INSURER B : California Automobile Insurance Company Viatron Systems, Inc. INSURER C: Hartford Fire Insurance Company INSURER D : 18233 S Hoover Street INSURER E : Gardena, CA 90248 INSURER F : COVERAGES CERTIFICATE NUMBER: CL2110516258 REVISION NUMBER: THIS 6 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 MAYBE 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, INSR AUULSUbK POLICYEFF P LI C Y EXP LTR TYPE OF INSURANCE INS❑ WVD POLICYNUMBER MMIDDIYYYY) JMMIDDrfYYYJ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES Ea occurrence S 1,000,000 MED EXP (Any one personi $ 10,000 PERSONAL&ADV INJURY s 1,000,000 A Y 57 SBAAV3417 10/20/2021 10/2012022 GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 2,000.000 POLICY ❑ JECTT ❑ LOC PRODUCTS - COMPIOPAGG $ 2,000,000 $ OTHER _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,,000,000 Ea accilert BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED Y BA0400DO015173 05/2612021 05/2612022 BODILY INJURY (Per accidenU $ AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED HNON-OWNED AUTOS ONLY AUTOS ONLY Per amtlenl `x UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 HCLAIMS-MADE AGGREGATE $ 2.000.000 A EXCESS LIAB 57 SBAAV3417 10120/2021 10/20/2022 DED I I RETENTION $ s WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERlEXECUTIVE ('] E.L EACH ACCIDENY $ OFFICERIMEMBER EXCLUDED? u NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, descnbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT s EACH CLAIM 1,000,000 ERRORS & OMMISSIONS LIABILITY C (PROFESSIONAL LIABILITY) 72 TE 0294266-21 0112512021 01125/2022 AGGREGATE 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be a8ached if more space is required) City of Santa Ana, Its officers, employees, agents and representatives have been named as additional insured as respect to the General Liability, per attached form SS00080405. Primary & Non -Contributory applies as well Also named as additonal insured per attached endorsement # MCAS51 0081 7-CA to the Auto Liability. ' 10 days notice of Cancellation for non-payment, 30 days for any Other reason. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, ACORD 25 (2016103) CA 92702 The ACORD name and logo are SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WtH THE POLICY PROVISIONS. 1988-2015 ACORD C marks of ACORD Roll Mnlr�artattixt�+t RE:mEwED & APPROVED B1': 7ft ;D&Td&d 'MW Risk Manager 1[larval Aide