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DATE(MM/DD/YYYY) <br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE <br /> 16. � 1 07/02/2024 <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. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> Wright, Finnegan Sikarter Insurance Associates NAME: DaULL essig <br /> 23001 La Palma A to PHONE <br /> A/C No Exf _(7 )2 - - 997 <br /> Yorba Linda, CA <br /> ADMDRESS: DLaesslg fcin ance. m <br /> License#: Ok93 NSURER(S)AAFORDING COV€RAGE NAlf# <br /> ngie INSURERA: O Mt %fitaA Pf PP94Ar <br /> INSURED INSURER B <br /> Sierra Cybernetics Inc <br /> 5140 E. La Palma Ave. wsuRER' <br /> Suite 201 4NREI L): a e. <br /> m1A uT <br /> Anaheim Hills, C 07 6 F <br /> IN .t F: <br /> COVERAGES R A M 6 _ 5 E1/ N R -51111 <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW H VE',CEN ISSUED TO THE INS RED NA AB E FOR HE POLITY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITI JN r r ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDLD 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. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY <br /> A X COMMERCIAL GENERAL LIABILITY Y 1034949260 04/20/2024 04/20/2025 EACH OCCURRENCE $ 2,000,000 <br /> CLAIMS-MADE DAMAGE TO RENTED <br /> X OCCUR PREMISES Ea occurrence $ 1,000,000 <br /> MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X POLICY PRO- ❑ LOC PRODUCTS-COMP/OP AGG $ <br /> OTHER: JECT <br /> $ <br /> A AUTOMOBILE LIABILITY 1034949260 04/20/2024 04/20/2025 (CEO,acccideDtsINGLE LIMIT $ 1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> X AUTOS ONLY X AUTOS ONLY Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED T7 RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? N I A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Bus Pers Prop 1034949260 04/20/2024 04120/2025 Limit 1,071 <br /> Deductible 500 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES ,AGENTS&REPRESENTATIVES ARE ADDITIONAL INSURED& <br /> PRIMARY WORDING APPLIES PER THE BLANKET ADDITIONAL INSURED ENDORSEMENT ATTACHED TO THE POLICY-AS <br /> REQUIRED BY WRITTEN CONTRACT. 30 DAY WRITTEN NOTICE OF CANCELLATION WILL BE PROVIDED TO THE CITY OF <br /> SANTA ANA,20 CIVIC CENTER PLAZA, SANTA ANA, CA 92701.30 DAY WRITTEN NOTICE OF CANCELLATION WILL BE GIVEN <br /> TO THE CERTIFICATE HOLDER IN THE EVENT OF POLICY CANCELLATION.THIS CERTIFICATE OF INSURANCE SUPERSEDES <br /> THE ONE ISSUED ON 3/31/23. <br /> CERTIFICATE HOLDER CANCELLATION <br /> THE CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRI <br /> THE EXPIRATION DATE THEREOF,NO RiekManaglrnentDivisinrt <br /> RISK MANAGEMENT DIVISION ACCORDANCE WITH THE POLICY PRC N.oRa"`<.. <br /> 20 CIVIC CENTER DRIVE o REVIEWED&�/,[4PPRCMmBY: <br /> 4TH FLOOR AUTHORIZED REPRESENTATIVE ' <br /> SANTA ANA, CA 92702 Risk Management Specialist <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by DLL on 07/02/2024 at 10:45AM <br />