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vigaauy sg <br />r nci ne Francine R. <br />AC"RO <br />Ilare�l ATE (MM/DDNYYY) <br />CERTIFICATE OF LIABILITY INSURAN jillareal Date:2021.0.22 <br />06/15/2021 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />NAME: SILVI CHA <br />INSURANCE LAND INSURANCE SERVICES <br />HOIC,NEExt: 213-388-5505 aC No: 213-388-7148 <br />E-MAIL ADDRESS: INSURANCELANDQGMAIL.COM <br />4032 WILSHIRE BLVD <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />SUITE 309 <br />INSURERA:EVANSTON INSURANCE COMPANY <br />35378 <br />LOS ANGELES CA 90010 <br />INSURED <br />INSURER B : UNI= FINANCIAL CAS CO. <br />INSURERC:UNITED STATES LIABILITY INS. CO. <br />25895 <br />VALLEY MAINTENANCE CORPORATION <br />INSURER D: I CW GROUP <br />27847 <br />11759 TELEGRAPH ROAD <br />INSURER E: TRAVELERS CASUALTY AND SURETY CO.1 <br />19038 <br />INSURER F <br />SANTA FE SPRINGS CA 90670 <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 />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />��� <br />CLAIMS -MADE OCCUR <br />♦ <br />3AA414169 <br />09/13/2020 <br />08/13/2021 <br />EACH OCCURRENCE <br />$ 11000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 100,000 <br />MED EXP (Any one person) <br />$ 5,000 <br />PRIMARY NON-CONTRIBUTORY <br />PERSONAL & ADV INJURY <br />$ 11000,000 <br />A <br />X <br />X <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />POLICY PRO ❑ LOC <br />JECT <br />PRODUCTS-COMP/OPAGG <br />$ INCLUDED <br />$ $25, 000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />03370309-0 <br />03/12/2021 <br />03/12/2022 <br />COEaMB acciINED dentdents NGLE LIMIT <br />$ 11000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />B <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />X <br />X <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per acci -Zt <br />$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />UMBRELLA LIAB <br />OCCUR <br />XL1578400C <br />05/02/202105/02/2022 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />HCLAIMS-MADE <br />AGGREGATE <br />$ 5,000,000 <br />C <br />EXCESS LIAB <br />DED RETENTION$ <br />PRODUCTS-COM/OP AGG <br />$ 11000, 000 <br />D <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? [Y] <br />(Mandatory in NH) <br />N / A <br />X <br />WSA 5037498 03 <br />09/13/2020 <br />08/13/2021 <br />PER OTH- <br />STATUTE I I ER <br />E.L. EACH ACCIDENT <br />$ 11000,000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 11000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 11000,000 <br />E CRIME 105620659 05/24/202105/24/2022 THIRD PARTY $1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space Is required) Agreement Number : A-2021-043 <br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written contract, <br />agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City <br />shall be excess and noncontributory." <br />This Policy may be canceled by the Company by giving to the Insured and to the additional insureds indic ated on the certificates of insurance <br />issued during the term of this policy, at least Thirty (30) days written notice of cancellation or in the case of non-payment of premium, at least <br />ten (10) days' written notice of cancellation." <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />THE EXPIRATION DATE THEREOF, <br />NOTICE WILL <br />BE DELIVERED IN <br />Risk Management Division <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza, 4th floor <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />/) <br />tl:iskMowgon tlDMslcn <br />REmEWED & APPROVED BY: <br />© 1988-2014 ACORD C <br />p. V� <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />®'' <br />Risk Management Analyst <br />