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A. DATE (MM/DDIYYYY) <br />CERTIFICATE OF LIABILITY INSURANCE 07/29/2021 <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 rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER NTA T CSIS Insurance Services <br />NAME: <br />CSIS Insurance Services PHONE 888 501-2747 FAX <br />vc. No. Extl ( ) IAIc„ No (805) 446-4881 <br />AIL ......... <br />certificates@csisonline.com <br />3315 Old Conejo Road INSURER(S) AFFORDING COVERAGE NAIC M <br />Thousand Oaks CA 91320 INSURERA: Benchmark Insurance Company 41394 <br />......._ _. <br />INSURED INSURER B <br />SLS Property Solutions Inc INSURER C t <br />919 East Santa Ana Blvd INSURER D <br />INSURER E .. <br />Santa Ana CA 92701 INSURER F <br />COVFRAr;FS rFRTIFICATF MI IMRFR• Maste as of 711912021 r.0 1saoeo. <br />THIS <br />IS TO CERTIFY THAT THE POLICIES OF <br />INSURANCE <br />LISTED BELOW HAVE BEEN ISSUED <br />TO THE INSURED <br />NAMED ABOVE <br />FOR THE POLICY PERIOD <br />INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, <br />TERM <br />OR CONDITION OF ANY CONTRACT <br />OR OTHER <br />DOCUMENT <br />WITH RESPECT TO WHICH THIS <br />CERTIFICATE <br />MAY BE ISSUED OR MAY PERTAIN, <br />THE <br />INSURANCE <br />AFFORDED BY THE POLICIES <br />DESCRIBED <br />HEREIN IS SUBJECT <br />TO ALL THE TERMS, <br />EXCLUSIONS <br />AND CONDITIONS OF SUCH POLICIES, <br />LIMITS <br />SHOWN MAY HAVE BEEN REDUCED <br />BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE WWW <br />AUUL <br />r <br />bUtSIJPOLICY <br />POLICY NUMBER ....w <br />EFF <br />MMIDD/YYYY <br />POLICY EXP <br />MMIDDIYYYY <br />......... LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE DOCCUR <br />EACH OCCURRENCE $ <br />Aa0E_"iTl7 1ffN ED <br />PREMISES (Ea occurrence) S <br />MED EXP (Any one person) ''. S <br />PERSONAL&ADV INJURY <br />s <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY D IECPRO- <br />ILOC <br />'.. PRODUCTS - COMP/OP AGO <br />S <br />OTHER: <br />$ <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accidenk) <br />S <br />BODILY INJURY (Per person) <br />'.. S <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per aocidenl) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY rJAMA.GE. <br />Pxr acrritwrv@. <br />$ <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE'' <br />S <br />DED RETENTION S <br />$ <br />WORKERS COMPENSATION <br />X1 PER OTH- <br />'4 <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? �Y <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />CST5021968 <br />07/28/2021 <br />07/28I2022 <br />STATUTE I I ER. <br />E.L EACH ACCIDENT <br />$ 1,000000 <br />E.L, DISEASE - EA EMPLOYEE <br />S 1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />--- <br />S 1,OOQ000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />A Waiver of Subrogation is granted in favor of the additional insured with respects to Workers' Compensation in accordance with the policy's provisions, per <br />attached, <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza 4th FI <br />AUTHORIZED REPRESENTATIVE <br />11 Santa Ana CA 92701 <br />cF"o Is:isieManagmenti?iviaian <br />WSW <br />©1988-2015 ACORD C REVIEWED & APPROVE D SY: <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ' Yf' <br />--� Risk Management Analyst <br />