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r ranane h. FrancineRVillareal <br />Date: 1120.09.02 <br />Villareal <br />10:18:53-07'00' <br />"� CERTIFICATE OF LIABILITY INSURANCE <br />DAT0813V2D/YYYY) <br />08/a1/2020 <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 />One Liberty Plaza <br />165 Broadway, Suite 3201 <br />CONTACT <br />NAME:PHONE <br />(866) 283-]122 <br />(AIC.No.E1): Nc No : (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />New York NY 10006 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAIC4 <br />INSURED <br />INSURER A: 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 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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested <br />WEN <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />MD <br />POLICY NUMBERLICY <br />MMIDD/YYYY <br />MMIDDIY YY <br />LIMITS <br />A <br />X <br />COMMERCIALGENERALLIABILITY <br />Y <br />Y <br />GL <br />EACHOCCURRENCE <br />$2,000,000 <br />CL41MS-MADE ❑% OCCUR <br />737,MAGE 10 REHTE. <br />PREMISES Ea occurrence <br />$2,000,000 <br />X <br />MED EXP (Any one person) <br />$10, 000 <br />XCU Conage is Included <br />PERSONAL A ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />% POLICY PROJECT LOC <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS - COMPIOP AGG <br />$5,000, 000 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />CA 4594298 <br />ADS <br />06/30/2020 <br />06/30/202 1 <br />COMBINED SINGLE LIMIT <br />Ea accident <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 />OWNED SCHEDULED <br />AUTOSONLY AUTOS <br />HIREDAUTOS NON-0WNED <br />ONLY AUTOS ONLY <br />MA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Per accitlenry <br />PROPERTY <br />^DAMAGE <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA LIAa <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LMB <br />CLAIMS -MADE <br />AGGREGATE <br />DEO <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERTLIABILITY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERaaEMBER EXCLUDED? N <br />NIA <br />WC045886576 <br />ADS <br />WC045886575 <br />06/30/2020 <br />06/30/2020 <br />06/30/2021 <br />06/30/2021 <br />X I PER STATUTE <br />OTH- <br />E <br />E.L EACH ACCIDENT <br />$1,000,000 <br />E. L. DISEASEEAEMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, de scribe under <br />CA <br />EL. DISEASE -POLICY LIMIT <br />$1,00D,000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if 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 'L01 <br />SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE J <br />POLICY PROVISIONS. Risk <br />Of Santa And POLICY <br />REPRESENTATIVE - <br />20 c Management Plaza, Oft - <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 USA c.XYoN/ss <br />_ RaiMnrgenelEDktdm <br />©1988-2015 ACORD COP REVEWE)5APPROVED Ili <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD P_ vj&w <br />®�4 c� <br />Risk fdareagernment Analyst <br />