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rranane ri. Francine R. Villareal <br />Date: 2020.09.02 <br />Villareal <br />,0:18:53 -0T00' <br />"✓ CERTIFICATE OF LIABILITY INSURANCE <br />OATEW3112020Y 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 />Ann Risk services Northeast, Inc. <br />NV Office <br />oNewne LYorkiberty <br />One Liberty , Plaza <br />Broadway, Suite 3201 <br />CONTACT <br />NAME: <br />PHONE (866) 283-7122 <br />IE-MAIL.E#): DVC No): (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />New <br />New York NV 10006 USA <br />INSURER(S) AFFORDING COVERAGE <br />NAIC W <br />INSURED <br />Los Angeles SNSA 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 />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 />INSR TYPE OF INSURANCE bush L POLICY LTR INSD WVD POUCYNUMBER MMIDDM'YY MMIDDMlYY LIMITS <br />A <br />X <br />COMMERCIALGENERALUABILITY <br />CLAIMS -MADE ❑X OCCUR <br />y <br />y <br />GL <br />EACHOCCURRENCE <br />$2,000,000 <br />A E D <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 />GEMLAGGREGATE LIMITAPPLIES PER: <br />❑ PR ❑ <br />% POLICY JECT LOC <br />GENERALAGGREGATE <br />$510001000 <br />PRODUCTS -COMPIOPAGG <br />$5,000,000 <br />OTHER' <br />A <br />AUTOMOBILE LIABILITY <br />CA 4594298 <br />ADS <br />06/30/202D <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />IEa accitlenf <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 />HIREDAUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />MA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Per accitlenq <br />PROPERTY DAMAGE <br />Per accident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBREI.LALIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />Cl-AIMS-MADE <br />AGGREGATE <br />DED <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERSLIABILITY YIN <br />ANY PROPRIETOR/ PARTNERI EXECUTIVE <br />OFFICERIVEMBER EXCLUDED? ❑ <br />(Mandatoryin NH) <br />If yes, describe under <br />NIA <br />WC045886576 <br />ADS <br />WC045886575 <br />CA <br />06/30/2020 <br />06/30/20201 <br />06/30/2021 <br />06/30/20Z1 <br />X <br />PER STATUTE <br />OTH- <br />EL EACHACCIDENT <br />$1,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS belaw <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached d more space is required) <br />The above -referenced General Liability policy shall cover the tart 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 =ii <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 USA <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 />AUTHORIZED REPRESENTATIVE <br />i el <br />. rwaragemo¢ urwswr <br />©1988-2015 ACORD CO REVIEWED& APPROVED Sr. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD lit® <br />® Kek ManTgerlent Analyst <br />