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Francine R. Villareal �k tlww�wn.,�Ke_
<br />ACOR& CERTIFICATE OF LIABILITY INSURANCE
<br />D09101020OrcYYY)
<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 poiicy(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
<br />CONTACT US Centralized Services
<br />NAME:
<br />Marsh USA Inc.
<br />PHONE 8669fi6-0664 ue Na
<br />701 Markel Sueet, Suite 1100
<br />SL Louis, MO 63101
<br />nooaess: AIt.CenRequest(ajmarsh.com
<br />Alin: ATT.Cer1Request@marshcom
<br />INSURERS AFFORDING COVERAGE
<br />NAICk
<br />INSURER A: Old Republic Insurance Company
<br />24147
<br />CNiD3150778-GAW-CRT-20-21 Y Y kvi66g Y
<br />INSURED
<br />New Cingulaz Wireless PCs, LLC
<br />INSURER B :
<br />INSURER C :
<br />One AT&T Plaza
<br />208 South Aland
<br />Room 1820
<br />INSURER 0:
<br />INSU0.ER E:
<br />Dallas, TX 75202
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: CHI-009523130-05 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 />rypE OF INSURANCE
<br />ADDLSUBR
<br />POUCYNUMBER
<br />POLICY EFF
<br />(IMMIDDANYIn
<br />POLICY EXP
<br />fMIWDOfTYYYILIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LABILITY
<br />CLAIMS -MADE M OCCUR
<br />MWZY 31363620
<br />0610112020
<br />0610112021
<br />EACH OCCURRENCE
<br />$ 2,000,000,
<br />DAMA TETORENTED
<br />PREMISES Ea adcurrancel
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />S NIA
<br />PERSONAL &ADV INJURY
<br />$ 2.000,000
<br />GENIE AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PRO-
<br />JECT LOC
<br />❑
<br />GENERAL AGGREGATE
<br />$ 10,000,000
<br />PRODUCTS -COMPIOP AGG
<br />3 2,000,000,
<br />S
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />MWTB 31363520
<br />06/01/2020
<br />06/0112021
<br />COMBINED SINGLE LIMIT
<br />E...Wenl
<br />$ 1,000,000,
<br />A
<br />X
<br />ANY AUTO
<br />MWZX 31363720 (MI}
<br />06/01/2020
<br />06/01/2021
<br />BODILY INJURY (Pa Pen.)
<br />S
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accident
<br />( )
<br />S
<br />HIRED NOWO MED
<br />AUTOS ONLY AUTOS ONLY
<br />AMAGE
<br />$
<br />11
<br />UMBRELLA LIAS
<br />OCCUR
<br />RENCE
<br />$
<br />VAGGRE��
<br />$
<br />EXCEBS LIAR
<br />CLAIMS -MADE
<br />DED RETENTIONS
<br />S
<br />_
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERV LIABILITY YIN
<br />OFFICERIMEMBER EXCLUDED? ❑N
<br />(Mandatory In NH)
<br />NIA
<br />MWC 31363820(ADS)
<br />06/01/2021
<br />OTH-
<br />E ERAN�YPROPRIETORIPARTNEWUECUTIVE
<br />CIDENT
<br />. S 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />S 1,000,000`
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Excess Workers' Compensation I
<br />MWXS 31363920 (ORWA)
<br />ON112020
<br />061012021
<br />EL Each Acpdent l EL Disease
<br />11000.000
<br />Employers' Liability
<br />See Second Page
<br />EL DiseasaPollcy Limit
<br />1000.000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Ramarke Schedule, may be a0ached If more apace is mgulred)
<br />Re City of Santa Ana Municipal Facilities License Agreement
<br />City of Santa An, its council members, officers, and employees islare included as Additional Insured under the General liability and Automobile Liability policies but only with respect to the requirements of the
<br />contract between the Certificate Holder and the Insured. Waiver of Subrogation is provided for General Liability, Automobile Liability and Workers' Compensation as required by written contract and allowable by,
<br />law. This insurance is primary with respect to the interest of the Additional Insured and any other insurance maintained by Additional Insured is excess and noo- onlydutery with this insurance.
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Risk Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza, 4th floor ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701
<br />of Marsh USA Mc. ra..�
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<br />BEytvim iAPMne,FwH»� 8r,.
<br />©1988.2016 ACORD C NoIi it esAww+Mlec
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORDry111O,,,�„r JM.air.r
<br />
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