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rranc)ne h. Francine RJVillareal <br />Villareal Date: 1120.09.02 <br />10:1 &53-07'00' <br />"� CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIOO/Y Y) <br />OB/31I2020 <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: <br />(NC.NNo. Exq: B66) 283-7122 FAX <br />No.): (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />New York NY 10006 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAIC is <br />INSURED <br />Los Angeles SMSA LPdba <br />vAvenuezon 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 />109 <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 />INS0LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY) (MMMDIYYYYl LIMITS <br />A <br />JXCCOMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ❑XOCCUR <br />Y <br />Y <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />ET ED <br />PREMISES Ea occurrenceU <br />$2,000,000 <br />MED EXP (Any one person) <br />$10, 000 <br />Coverage is Induced <br />PERSONAL a ADV INJURY <br />$2,000,000 <br />GENIAGGREGATE LIMITAPPLIES PER: <br />PRO- <br />X POLICY JECT LOC <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS -COMP/OPAGG <br />$5,000,000 <br />OTHER : <br />A <br />LIABILITY <br />CA 4594298 <br />ADS <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />Ea accide t <br />$1,000,000 <br />BODILY INJURY ( Per person) <br />A <br />NYTOCA <br />4594299 <br />06/30/2020 <br />06/30/2021 <br />5MOEUL, <br />WNSCHEDULED <br />AUTOS <br />NLY AUTOS ONLY <br />NIA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021IRED.SNOWONMEDPROPERTYDAMAGE <br />BODILY INJURY(PeraccklnqAUTOONLY <br />Per accident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />H <br />CLAIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY YIN <br />ANY PROPRIETOR PARTNER EXECUTIVE <br />OFFICERJMEMBER EXCLUDED? <br />N/A <br />WC045886576 <br />ADS <br />wC04588fi575 <br />06/30/20M <br />06/30/2020 <br />06/30/2021 <br />06/30/2021 <br />X <br />I PER STATUTE <br />OTH- <br />ER <br />E.L. EACHACCIDENT <br />$1,000,000 <br />If yes, describe ory in NH) <br />If yes,r,inunder <br />CA <br />E.L. DISEASE -EA EMPLOYEE <br />$1, 000, 000 <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1.000, 000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addaional Remarks Schedule, may be adaehed 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 poi Cy. 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 />N <br />,n <br />m <br />0 <br />n <br />N <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBE. POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE J <br />POLICY PROVISIONS. - <br />city Of Santa Ana AUTHORIZED REPRESENTATIVE - <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 USA <br />ICuMancgemrnE Dhition <br />©1988-2015 ACORD COS �:® enEcl& APPROv8r. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ?` <br />Kok Management Anatyst <br />