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r ranane K. Francine R Villareal <br />Date: 2020.09.D2 <br />Villareal <br />10:18:53-07�00' <br />'4C<>MCERTIFICATE OF LIABILITY INSURANCE <br />OATOSM112020 <br />DMI31/2020 <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(les) must have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endomement(s). <br />PRODUCER <br />Aon Risk Services Northeast, Inc. <br />New VOrk NY Office <br />One Liberty Plaza <br />165 Broadway, Suite 3201 <br />CONTACT <br />NAME: <br />PHONE 263-7122 <br />TAIL. No. Exl); (866) � No (R00) 363-0105 <br />E-MAIL <br />ADDRESS: <br />New York NV 10006 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURED <br />Los Angeles SMSA LP <br />dba Verizon wireless <br />INSURER A: National Union Fire Ins CO of Pittsburgh <br />19445 <br />INSURER B: AIU Insurance Company <br />19399 <br />INSURER C: American Home Assurance Co. <br />19380 <br />1095 Avenue of the Americas <br />New York NY 10036 USA <br />INSURER D: New Hampshire Insurance Company <br />23841 <br />INSURER E: <br />INSURER F. <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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested <br />LTR TYPE OF INSURANCE INSC WVD POLICYNUMBER POUCMMIDD� MM/ODEXP ILIMITS <br />A <br />MMERCIAL GENERALLIABILRY <br />Y <br />Y <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIM& -MADE ❑X OCCUR <br />TX7X_1 <br />OA RENTED <br />PREMISES Ea occurrence <br />$2,000,000 <br />MED EXP (Any one person) <br />$1Q 000 <br />U Coverage is Included <br />PERSONAL& ADV INJURY <br />$2,000,000 <br />GENLAGGREGATE UMITAPPLIES PER: <br />PRO <br />X POLICY JECT F—] LOC <br />GENERALAGGREGATE <br />$5, 000, 000 <br />PRODUCTS-COMP/OPAGG <br />$5, 000, 000 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />CA 4594298 <br />ADS <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />Ee eo'dent <br />$1, 000, 000 <br />A <br />X ANYAUTO <br />CA 4594299 <br />06/30/ZO2006/30/2021 <br />BODILY INJURY (Par person) <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIREDAUTOS NON-0WNEO <br />ONLY AUTOS ONLY <br />MA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Par a..an,) <br />PROPERTY DAMAGE <br />Per accident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLALIAB <br />H <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CIAIMS-MADE <br />AGGREGATE <br />DEp <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERs'LIABILITY Y/N <br />ANY PROPRIETOR I PARTNERI EXECUTIVE <br />OFFICERMEMBER EXCLUDED? <br />(Mandatory in NHl <br />It yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />WC045886576 <br />ADS <br />WC045886575 <br />CA <br />06/30/2020 <br />06/30/2020 <br />06/30/2021 <br />06/30/2021 <br />X PER STATUTE <br />OTH- <br />ER <br />E.L EACHACCIDENT <br />$1,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may the attached R more space is required) <br />The above -referenced General Liability policy shall cover the tort liability of the Certificate Holder assumed under the <br />underlying agreement between parties for which the certificate has been issued. City of Santa Ana, its council members, <br />officers and employees are included as Additional Insured with respect to the General Liability policy. The General Liability <br />policy shall apply as Primary and Non -Contributory Insurance to each Additional insured listed herein, where permitted by law, <br />the Named insured parties listed herein waive all rights against City of Santa Ana, its council members, officers and employees <br />listed herein for recovery of damages to the extent these damages are covered by the above -referenced General Liability policy <br />and, as further limited by written contract between the parties. <br />0 <br />Z <br />A <br />;E <br />N <br />U <br />CERTIFICATE HOLDER CANCELLATION L" <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE I <br />POLICY PROVISIONS.city of Santa Ana AUTHORI2ED REPRESENTATIVE <br />Risk Management DivisiOn <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 USA /i]� o �O`C� <br />�,.eA-.` [fist Management Division <br />01988-2015 ACORD CO - )'"`s' ReAE#ED6APPaov®8Y: <br />ACORO 25 (2016103) The ACORD name and logo are registered marks of ACORD ."I®x FiAwL++ P_ vitMeAI <br />�i Rek Management Analyst <br />