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rranClne n. Francine R Villareal <br />Date: 2020.09.02 <br />Villareal <br />10:18:53 -07'00' <br />"� o CERTIFICATE OF LIABILITY INSURANCE <br />°ATOBM/31=0 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 />ADD Risk Services Northeast, Inc. <br />New York NV Office <br />One Liberty ,Plaza ui <br />New Broadway, Suite 3201 <br />New York NY 10006 USA <br />CONTACT <br />NAME: <br />PHONE (866) 283-7122 FAX <br />INC. Earl: = NO : C800) 363-0105 <br />IL <br />E-MAIL <br />ADORess: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURED <br />LOS Angeles SMSA LP <br />dba verizon wireless <br />INSURERA: National Union Fire Ins CO of Pittsburgh <br />19445 <br />INSURER B: AID 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 />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 />POUCYNUMBER <br />PQUCYMMmC EFF <br />POLIC EX <br />LIMITS <br />A <br />X <br />COMMERCRLGENERALLIABILITY <br />Y <br />GL <br />EACHOCCURRENCE <br />$2, 000, 700 <br />CLAIMS -MADE ❑X OCCUR <br />DAW$2,000, <br />occurrence <br />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 />GENIAGGREGATE LIMITAPPLIES PER: <br />PRO <br />% POLICY JECT LOC <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS - COMP/OPAGG <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 />Ee accident <br />$1, 000, 000 <br />BODILY INJURY(Pef person) <br />A <br />X ANYAOTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />OWNEDTOSU�D <br />AUTOS ONLY <br />HIREDAUTOS NON -OWNED <br />ONLY AUTOS ONLY <br />MA' <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Per acciden0 <br />PROPERTYDAIMGE <br />Per accident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAR <br />CI -AIMS -MADE <br />AGGREGATE <br />IDED1 <br />RETENTION <br />B <br />D <br />WORKERS COMPENSATION AND <br />EMPLOYERS'UABILRY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERRIEMBER EXCLUDED? <br />NIA <br />wc045886576 <br />ADS <br />WC04568657$ <br />06/30/20M <br />06/30/202006/30/2021 <br />06/30/2021 <br />X I PER STATUTE <br />OTH- <br />ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />CA <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addeional Remarks Schedule, may be attached 8 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 0 <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 />Risk <br />Of Santa And AUTHORIZED REPRESENTATIVE <br />2- <br />0sk Management Division l0 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 USA <br />Rid[ Man% mrnf Dhisml <br />+' T REv1EveED b APPROVED By. <br />©1988-2016 ACORD CO <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />RBk Management Analyst <br />