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rranc(ne K. FrancineR.'Villareal <br />Date: 2020.09.02 <br />Villareal <br />10:18:53-07'00' <br />"e �® CERTIFICATE OF LIABILITY INSURANCE <br />DAI 0513112020 <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 />PHONE (Bfi6) 283-7122 <br />(" No. EXO: aC No : (800) 363-0105 <br />EMAIL <br />ADDRESS: <br />New York NY 10006 USA <br />INSURERS) AFFORDING COVERAGE <br />NAIL 4 <br />INSURED <br />Los Angeles SMSA LP <br />dba verizon 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 />1095 Avenue of the Americas <br />New York NV 10036 USA <br />INSURER D: New Hampshire Insurance company <br />23841 <br />NSURER E: <br />d <br />----------- <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 <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICYNUMBER <br />PULIUYEFF <br />MMIDDIYYYY <br />P <br />MMIDD <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERALUABILITY <br />CLAIMS -MADE ❑X OCCUR <br />I <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />A RELATE <br />PREMISES Ea occurrence <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 />GENTAGGREGATE LIMITAPPLIES PER: <br />% POLICY PRO-JECT LOC <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS-COMPIOPAGG <br />$5,000,006 <br />OTHER: <br />A <br />AUTO MOBILE LIABILITY <br />CA 4114111 <br />ADS <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />Ea ac 'dent <br />$1,000.000 <br />A <br />X ANVAUTO <br />CA 4594299 <br />O6/30/202006/30/2021 <br />BODILY INJURY (Per person) <br />A <br />OWNED SCHEDULED <br />ONLY <br />HIREOF_cxer NON -OWNED AUTOS <br />ONLY AUTOS ONLY <br />H <br />MA <br />LA 4594300 <br />VA <br />06/30/202006/30/2021 <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per accider <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA LIAB <br />H <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />DED RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY YIN <br />ANY PROPRIETOR/ PARTNER I EXECUTIVE <br />OFFICERRAEMBER EXCLUDED? N <br />(Mandatory in NH) <br />Ryes. RIPTIONibe antler <br />DESCRIPTION under <br />OPERATIONS below <br />N/A <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 />I <br />OTH- <br />Eft <br />E.L EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE- EA EMPLOYEE <br />$1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,00C <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached IF mare 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 poiiCy. 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 />G <br />0 <br />2 <br />is <br />IS <br />Y <br />0 <br />O <br />1-tH I R-II:AI t HULULK CANCELLATION al <br />SHOULD ANY 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. - <br />city of Santa Ana AUTHORIZED REPRESENTATIVE a� <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 USA <br />RuiManVement Dikirlm <br />©1988-2015 ACORD CO o p 6APmw®BY° <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD �I' ! fusrrK <br />Risk Management Analyse <br />