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t-ranane K. Francine RVillareal Date: 2020.09.02 Villareal 10:18:53-07'00' CERTIFICATE OF LIABILITY INSURANCE OATE(MM/ OB/0 DDN2020 1 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 endomement(s). PRODUCER Ann Risk Services Northeast, Inc. New York NY Office One Liberty Plaza 165 Broadway, Suite 3201 CONTACT NAME: PHONE 283-]122 (AJC.N..Exq: (866) aC No : (800) 363-0105 E-MAIL ADDRESS: New York NY 10006 USA INSURER(S) AFFORDING COVERAGE NAIC 8 INSURED LOS Angeles SMSA LP dba Verizon wireless INSURER A: Nati Onal UDIOn Fire Ins CO of Pittsburgh 19445 INSURER B: AIU Insurance Company 19399 INSURER C: American Home Assurance Co. 19380 1095 Avenue of the Americas New York NV 10036 USA INSURER D: New Hampshire Insurance Company 23841 INSURER E: INSURER F: THIS IS 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDT x LIMITS A X COMMERCIAL GENERAL LIABILITY CI -AIMS -MADE❑% OCCUR Y GL 1 EACH OCCURRENCE $2,000,000 _DPRE T PREMISES Ea occunence $2,000,000 X MED EXP (Any one person) $10, 000 XCU Coverage is Included PERSONAL a ADV INJURY $2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: PRO - POLICY DJECT 0 LOC GENERALAGGREGATE $5,000,C00 PRODUCTS-111WOPA11 55,000,000 OTHER: A AUTOMOBILE LIABILITY CA 4594298 ADS 06/30/2020 06/30/2021 COMBINED SINGLE LIMIT Itcibent $1,000,000 A % ANYAUTO CA 4594299 06/30/2020 06/30/2021 BODILY INJURY(Per person) A OWNED SCHEDULED AUC)SONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY MA CA 4594300 VA 06/30/2020 06/30/2021 BODILY INJURY (Per acdtlent) PROPERTY DAMAGE Per acGtlenl A See Next Page 06/30/2020 06/30/2021 UMBRELLALIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION B O WORKERS COMPENSATION AND EMPLOYERS'LABILnY YIN ANY PROPRIETOR I PARTNER I EXECUTIVE OFFICERIMEMBER EXCWCEDT (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS be. N/A wc045886576 ADS WCO4S886S75 CA 06/30/2020 O6/30/2020 06/30/2021 O6/30/2021 X PERSTATUTE OTH- ER E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE -EA EMPLOYEE $1,000,000 EL DISEASEPOLICYLIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1AC ORD 101 Additional Remarks Schedule, may be attached 8 more space is mquiretl) The above -referenced General Liability policy shall cover the tort liability of the Certificate Holder assumed under the underlying agreement between parties for which the certificate has been issued. City of Santa Ana, its council members, officers and employees are included as Additional Insured with respect to the General Liability policy. The General Liability policy shall apply as Primary and Non -Contributory Insurance to each Additional Insured listed herein. where permitted 6y law, the Named Insured parties listed herein waive all rights against City of Santa Ana, its council members, officers and employees listed herein for recovery of damages to the extent these damages are covered by the above -referenced General Liability policy and, as further limited by written contract between the parties. `v CERTIFICATE HOLDER CANCELLATION --� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROWSIONS. city of Santa Ana AUTHORIZED REPRESENTATIVE Risk Management Division 20 Civic Center Plaza, 4th Floor � Santa Ana CA 92701 USA ©1988-2015 ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD REVIEWED & APPROV® BY. F «c a t Z vjb/ d Ruk Management Analyst