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rranane i'i. Francine R.-Villareal <br />Date: 2020.09.02 <br />Villareal <br />10:18:53 -07'00' <br />''� CERTIFICATE OF LIABILITY INSURANCE <br />OATEO(WM12020 Y) <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 endomement(s). <br />PRODUCER <br />Aon Risk Services Northeast, Inc. <br />New York NV Office <br />One Liberty Plaza <br />165 Broadway, Suite 3201 <br />New York NV 10006 USA <br />CONTACT <br />NAME: <br />PHONE (gfi6) 283-7122 FAX (800) 363-0105 <br />INC. No.em): AIC No.): <br />E MAIL <br />- <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC If <br />INSURED <br />Los Angeles SMSA LP <br />dba verizon Wireless <br />INSURERA: NdilOndl Uni On 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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested <br />LTR TYPE OF INSURANCE INSO WVD POUCYNUMBER MMIDDfIYYY MMIDOIYVYY LIMITS <br />A <br />;XLCCMMEFGIALGENERALUABIL ITY <br />CIAIMSMWDEFXI OCCUR <br />Y <br />GL <br />EACH OCCURRENCE <br />$2.000,000 <br />ET <br />PREMISES Ea o¢unenceU <br />$2,000,000 <br />MED EXP(Any one person) <br />$10,000 <br />Coverage is lndutletl <br />PERSONAL &ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />X POLICY JECT PRO - LOG <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS - COMPIOPAGG <br />$5,000,000 <br />OTHER. <br />A <br />AUTOMOBILE LIABILITY <br />CA 4594298 <br />A05 <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />(Ea acoden <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 />AUTOS ONLY AUTOS HIREDAIROS NON -OWNED <br />ONLY AUTOS ONLY <br />NIA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Pie acO enry <br />PROPERTY DAMAGE <br />Per accident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CIAIMS-MADE <br />AGGREGATE <br />OEO <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERTLIABILITY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFF[ EXCLUDED? <br />(Mandatory in NH) <br />If we, describe under <br />DESCRIPTION OF OPERATIONS be. <br />NIA <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 <br />PER STATUTE <br />OTH- <br />R <br />EL EACH ACCIDENT <br />$1, 000, DD0 <br />EL DISEASE -EA EMPLOYEE <br />$1,000,000 <br />EL DISEASE-POUCY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLEB (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,l <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 />N <br />U <br />i <br />e <br />U <br />CERTIFICATE HOLDER CANCELLATION i:ei <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 <br />Santa Ana CA 92701 USA <br />IrM4Managtanmf DiLtdm <br />©1988-2015 ACORD COR <br />REVIEWED 6 APPROVED Br <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Fuh�na.[ P. M4,&'t <br />® RLsk MarsagemLYU Analyst <br />