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Client#: 1252713 <br />Francine R. Villareal villuailly s"°`a nyF,a0d0e a. <br />305STRADYOC Data: 2021 o3.09 19 sa:4)-09 pe <br />ACORDTa CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DDNYYY) <br />3/08/2021 <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 any rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT Kimberly Elfring <br />McGriff Insurance Services <br />o 877 297-9247 <br />a/c° No EXl : 714 941-2822 A C, Mal <br />2400 E Katella Ave Suite 1100 <br />ApDRIEss, kelfring@MCGriff.com <br />Anaheim, CA 92806 <br />INSURER(S) AFFORDING COVERAGE <br />NAICN <br />INSURER A: Vigilant Insurance Company <br />20397 <br />INSURED <br />INSURER B: Federal Insurance Company <br />20281 <br />Stradling Yocca Carlson & Rauth APC <br />660 Newport Center Drive, Suite #1600 <br />INSURER C: <br />Newport Beach, CA 92660 <br />INSURER D: <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 CONTRACTOR 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 />INRR <br />TYPE OF INSURANCE <br />ADDLSUB <br />INSR <br />WVD <br />POLICYNUMSER <br />POLICY EFF <br />MMIDDNYYY <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERALLIABILITY <br />CLAIMS -MADE OCCUR <br />X <br />35327003 <br />05/01/2020 <br />05/01/2021 <br />EACH OCCURRENCE <br />$1,000000 <br />PREMISES EaEoccorrance <br />$1 00O 000 <br />MED EXP (Any one Parson) <br />$1 O 000 <br />PERSONAL B ADV INJURY <br />$1 000,000 <br />GEWL <br />X <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY J COT LOC <br />GENERALAGGREGATE <br />$2,000,000 <br />PRODUCTS <br />$INCLUDED <br />D <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />74988851 <br />0510112020 <br />05/01/2021 <br />COMBINED SINGLE LIMIT <br />Eaeccldent <br />1,000,000 <br />BODILY INJURY (Par person) <br />$ <br />ANYAUTO <br />SCHED <br />AUTOS ONLY AUTOSULED <br />BODILY INJURY (Per aocldent) <br />$ <br />X <br />HIRED NON -OWNED <br />AUTOS ONLY X AUTOS ONLY <br />PROPERTY DAMAGE <br />Per eccldenl) <br />$ <br />B <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />79726620 <br />5/01/2020 <br />05/01/2021 <br />EACHOCCURRENCE <br />$27OOO OOO <br />AGGREGATE <br />$27,000 000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />2071700994 <br />11/0312020 <br />11/03/2021 <br />X PER OTH- <br />E.L. EACH ACCIDENT <br />$1 OOO OOO <br />E.L. DIGEASE-EA EMPLOYEE <br />$1 000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />OE8 RIPTIONOFOPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />RE: Contract Agreement; RFP No. 20.160 <br />Certificate Holders name is amended to include: City of Santa Ana, its officers, employees, agents, <br />volunteers and representatives <br />Certificate holder is included as Additional Insured including Primary/Noncontributory wording with <br />respects to General Liability as required by written contract, per form attached. <br />60 Day Notice of Cancellation/Nonrenewal (20 Day in the event of non-payment) applies per form attached. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th floor <br />Santa Ana, CA 92701 <br />ACORD 25 (2016/03) 1 Of 1 <br />#S27490946/M25661247 <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 />AUTHORIZED REPRESENTATIVE <br />3I-AftDIH_ oro--c -&w <br />©1988-2015 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />y.� RiaFiHanaBementDlWsian <br />r� REVIEWED&APtPIRo�}vEDSr/ kg,� <br />; FroA.Aa�at h. YyLcfiA4RL �4 <br />�1. <br />Risk ManagementAnalyst <br />