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rranclne K. Francine R. Villareal <br />Date: 1020.09.02 <br />Villareal <br />10:18:53-07'00' <br />A`iRl7® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMI00/YY1'V) <br />08131/2020 <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. 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 endorsement(s). <br />PRODUCER <br />Aon Risk Services Northeast, Inc. <br />New York NY Office <br />CONTACT <br />NAME: <br />PHONE (866) 283-7122 <br />INC. No. Ext): FAX <br />No.: (B00) 363-0105 <br />One Liberty Plaza <br />165 Broadway, Suite 3201 <br />E-MAIL <br />ADDRESS: <br />New York NY 10006 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURED <br />INSURERA: National Union Fire Ins Co Of Pittsburgh <br />19445 <br />Los Angeles SMSA LP <br />dba Verizon wireless <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 NV 10036 USA <br />INSURER D: New Hampshire Insurance Company <br />23841 <br />INSURER E: <br />INSURER F: <br />VVVCKAbCJ UCK I INUA IC IMUMCCK: O I UUOJIJOODO KtVIJILN NUMHtH' <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. Limits shown are as requested <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVO <br />POLICY NUMBER <br />MMIDOnYTY1 <br />HIMIDDYYYYILIMITS <br />A <br />X <br />C MMERCIALGENERALUABILITY <br />GL17 <br />EAOHOCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE ❑X OCCUR <br />DAMA ETO <br />PREMISES Eaacwnence <br />$2,000,000 <br />X <br />MED EXP (Any one person) <br />$10, 000 <br />XCU Coverage is Included <br />PERSONAL&ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE UMITAPPLIES PER: <br />GENERALAGGREGATE <br />$5,000,000 <br />X POLICY ❑JET LOC <br />PRODUCTS-COMP/OPAGG <br />$5,000,006 <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 />Ea.. die <br />$1,000,000 <br />BODILY INJURY (Per person) <br />A <br />X ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIREDAUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />MA <br />CA 4594300 <br />VA <br />See Next Page <br />06/30/2020 <br />06/30/2020 <br />06/30/2021 <br />06/30/2021 <br />BODILY INJURY (Per acoden0 <br />PROPERTY DAMAGE <br />Pero dard <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />NIA <br />wc045896576 <br />ADS <br />WC045886575 <br />CA <br />06/30/2020 <br />06/30/2020 <br />06/30/2021 <br />06/30/2021 <br />X I PER STATUTE <br />OTH- <br />ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />If yes, describe ender <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES IACORD 101, Additional Remarks Schedule, may be attached 8 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 />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />City Of Santa Ana AUTHORIZED REPRESENTATIVE <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor 4 �✓sb ad <br />Santa Ana CA, 92701 USA Plaza, <br />©1988-2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />m <br />c <br />m <br />'O <br />0 <br />O <br />S <br />do <br />N <br />m <br />w <br />m <br />O <br />0 <br />n <br />O <br />2 <br />RI <br />U <br />C <br />0 <br />U <br />KUMnlermgeltmr.uMam <br />REVIEWED &APPRON®BY: <br />Rtsk Management Analyst <br />