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rranane K. Francine R.'Villareal <br />Date: 2020.09.02 <br />Villareal <br />IDA 8:53-07'00' <br />"� �® CERTIFICATE OF LIABILITY INSURANCE <br />D <br />0MMIOATE(MMIN <br />12020 YI <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 />AGO Risk Services Northeast, Inc. <br />New York NV office <br />One Liberty Plaza <br />165 Broadway, Suite 3201 <br />CONTACT <br />NAME: <br />PHONE (866) 283-7122 F <br />INC. No. Exl): AlCA% No )o (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />New York NY 10006 USA <br />INSURERS) AFFORDING COVERAGE <br />NAICI <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 NY 10036 USA <br />INSURER D: New Hampshire Insurance Company <br />23841 <br />NSURER E. <br />NSURER 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 />POLICY NUMBER <br />POLICY MMIDD F <br />MMIDOIY YY <br />LIMRS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIM&MADE ❑X OCCUR <br />DAMA ENTEO <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 />GEN'LAGGREGATE LIMITAPPLIES PER: <br />PRO- <br />X POLICY EJECT LOC <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS-COMP/OP AGG <br />$5, 000, 000 <br />OTHER: <br />A <br />AUTO MOBILE LIABILITY <br />CA 4594298 <br />ADS <br />06/30/2D2006/30/2021 <br />COMBINED SINGLE LIMIT <br />Ea ac'Eent <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 <br />HIREDAUrOS NOVOWNEO <br />ONLY AUTOS ONLY <br />MA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (pre accieanq <br />PROPERTY DAMAGE <br />Peraccidenl <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY Y/N <br />ANY PROPRIETOR OFFICERIMEM ERIEXCL DEDiPARTNER I ECUTIVE <br />NIA <br />WC045886576 <br />ADS <br />wC045886575 <br />06/30/2020 <br />06/30/2020 <br />06/30/2021 <br />06/30/202 1 <br />X I PERSTATUTE <br />DTH- <br />ER <br />EL. EACH ACCIDENT <br />$1,000,000 <br />EL DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If unders, describe <br />CA <br />E.L. DISEASE -POLICY LINT <br />$1,000,000 <br />DESCRIPTION <br />RIPTIONO OF below <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached R 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 <br />N <br />0 <br />m <br />m <br />0 <br />n <br />N <br />O <br />2 <br />R <br />E <br />0 <br />L) <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 />Rity of ManagSantaement <br />And AUTHORIZED REPRESENTATIVE <br />Risk Management Plaza, On Z1 <br />20 Civic Center Plaza, 4th Floor r a�s6etnacd �r <br />Santa Ana CA 92701 USA <br />RakMaragrati tDiw or, <br />©1988-2015 ACORD CO REAEVF.D& APPRw®BY: <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />this Management Analyst <br />