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CERTIFICATE OF LIABILITY INSURANCE <br />Francine R. Digitally signed ey Francine R. <br />Villareal iflar l <br />DATE (MMIODIYYYY) <br />11/13/2020 <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 Cornish Insurance <br />CONTACT Blake Cornish <br />NAME: <br />8816 South Sepulveda Blvd, Ste 108 <br />Los Angeles CA 90045 <br />aCDNNe E, . 310-215-3638 AA rve l 310-496-0627 <br />E AD-MDAIL <br />RESS: Blake@cornishinsurance.com <br />INSURER(S)AFFORDINGCOVERAGE <br />NAIC# <br />INSURER A: Northfield Insurance Company <br />27987 <br />INSURED Sensemakers LLC <br />INSURER B: Truck Insurance Exchange <br />21709 <br />2401 East Katella Ave Ste 610 <br />Anaheim CA 92806 <br />INSURER C: National Union Fire <br />INSURERD: <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDWYYYY <br />POLICY EXP <br />MOLICY YYY <br />LIMITS <br />t/ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE O OCCUR <br />`/ <br />`/ <br />WS438940 <br />11/28/2020 <br />11/28/2021 <br />EACHOCCURRENCE <br />$ 1,000,000 <br />OHMAGE TO RENT D <br />PREMISES Eaoaerrence <br />$ 50,000 <br />via <br />MED EXP(Any one person) <br />$ 5,000 <br />CGL-Per Occurance <br />V <br />Professional -Claims Made <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />A <br />BENL <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ Ji LOC <br />GENERAL AGGREGATE <br />$2,000,000 <br />PRODUCTS - COMPIOPAGG <br />$ 1,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITYLi <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />H <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />(P) <br />BODILY INJURY er accident <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />t/ <br />UMBRELLALIAB <br />Ll <br />OCCUR <br />00 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />C <br />I EXCESS LIAB <br />CLAIMS -MADE <br />EBU 064522034 <br />06/16/2020 <br />06/16/2021 <br />AGGREGATE <br />$ 1,000,000 <br />DED RETENTION$ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS. LIABILITY YIN <br />ANYPROPRIETOWPARTNERIEXECUTIVE <br />OFFICER/MEMBEREXCWDED? N❑ <br />(Mandatory in NH) <br />NIA <br />A09599357 <br />05/09/2020 <br />05/09/2021 <br />PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />Each Occurrence <br />$2,000,000 <br />C <br />Professional Liability <br />CX 1554951 <br />11/28/2019 <br />11/28/2020 <br />Aggregate <br />$2,000,000 <br />00 <br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached ifmore space birequlred) <br />City of Santa Ana, its officers, employees, agents and representatives are additional insured with respect to general liability per attached <br />endorsements as required by written contract. Insurance is primary and non-contributory. Wavier of Subrogation applied to workers <br />compensation. <br />30 days Notice of Cancellation with 10 days notice for non-payment of premium in accordance with the policy provision. <br />CITY OF SANTA ANA <br />Risk Management Division <br />20 CIVIC CENTER PLAZA 4th Floor <br />SANTA ANA, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Blake Cornish <br />01988-2015 ACORD C <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Riak ManagMnmt Dlwalon <br />A �4 NEvIEWED$. APPROVED BY <br />Risk Mona0ement An glyl <br />