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rranorle K• Francine R Villareal <br />Date: 2020.09.02 <br />Villareal <br />10:18:53 -07'00' <br />°`✓ o CERTIFICATE OF LIABILITY INSURANCE <br />OAT08131 20 YV) <br />OMWDD20 <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 />New York NY 10006 USA <br />CONTACT <br />NAME: <br />PHONE (g66) 283-7122 <br />(Al.. No.Eat): AIC ND ): (gDD) 363-0105 <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAICX <br />INSURED <br />LOS Angeles SMSAwire LPdha <br />vAvenuezon wireless <br />INSURERA: National union Fire Ins Co of Pittsburgh <br />19445 <br />INSURER B: AIU Insurance Company <br />19399 <br />109 <br />1095 Avenue of the Americas <br />New York NY 10036 USA <br />INSURER c: American xome Assurance Co. <br />19380 <br />INSURER D: New Hampshire Insurance Company <br />23841 <br />NSURME 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.INSR Limits shown areas requested <br />LTR TYPE OF INSURANCE AUDI INSD WVO POLICY NUMBER MMMDIYYYY MMIDof LIMITS <br />A <br />X <br />COMMERCIAL GENERALLIABILITY <br />CLAIMS -MADE ❑X OCCUR <br />Y <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />A TED <br />PREMISES Ea occunence <br />$2,000,000 <br />X <br />VIED EXP (Any one person) <br />$10, 000 <br />XCU Coverage is Included <br />PERSONAL a ADV INJURY <br />$210001000 <br />GENLAGGREGATE LIMITAPPLIES PER <br />PRO <br />% ❑ IRO, LOG POLICY <br />JECTCOMP/OPAGG <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS- <br />$5,000,000 <br />OTHER' <br />A <br />AUTOMOBILE LIABILITY <br />CA 4594298 <br />ADS <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />IEa accident <br />S1,000,000 <br />BODILY INJURY (Per person) <br />A <br />ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />P <br />MA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per accident <br />A <br />11 <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA LIAB <br />H <br />OCCUR <br />FACHOCCURRENCE <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR IPARTNER IEJIECUTIVE N <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatary in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />WC045886576 <br />A05 <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 />JOT, <br />ER <br />EL EACH ACCIDENT <br />$1, 000,000 <br />EA- DISEABE-EA EMPLOYEE <br />$1, 000, 000 <br />E.L. DISEASEPOLICYLIMIT <br />$1, 000, 000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be arached if mom space is required) <br />The above -referenced General Liability policy shall cover the tart liability of the Certificate Holder assumed under the i <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 />d <br />tt <br />'O <br />0 <br />O <br />2 <br />UCKI Irn-AI C MULUCK CANCELLATION UFO <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 Pl <br />aza, laza, 4th Floor <br />Santa Ana CA Center <br />USA <br />RuiLM.Wmmod Dheaiwl <br />©1988-2015 ACORD CO l�vlEwEn 6 APPROVED &r' <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD I~ <br />Rek Management Analyst <br />