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rl ai lunc n. v wal cai .,,,tees, Date: 2020.09.2114:00:4807'00' a a� CERTIFICATE OF LIABILITY INSURANCE Dnrg/15/2020YY> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MHBT, a Marsh & McLennan Agency, LLC company 8144 Walnut Hill Lane, 16th FI Dallas TX 75231 CONTACT NAME: Stacy Brimer PHONE AX No ; 972-376-8108 EMAIL ADDRESS: staC brimer mhbt,com INSURERS AFFORDING COVERAGE NAICH INSURER A: Hartford Casualty Insurance Company 29424 INSURED HUITTZOL Inc. 1717Z McKinney 1717 McKinney Ave., Ste. 1400 INSURER B: Federal Insurance Company 20281 INSURER C: Hartford Fire Insurance Company 30104 INSURER D : Dallas TX 75202-1236 NS-il E: NSURER F: COVERAGES CERTIFICATE NUMBER: 899364110 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. HER LTR TYPE OF INSURANCE ADDL D SUBR WVDI POLICY NUMBER POLICY EFF MMIDDM'YY POLICY EXP MMIDDfYYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR 46UUNOL6275 9/1/2020 9/1/2021 EACH OCCURRENCE $1000000 DAMAGE TO RENTED PREMISES Ea occurrence $300000 MED EXP (Any one person) $10000 PERSONAL &ADV INJURY $1000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEa [X] [X] LOG GENERAL AGGREGATE $2000000 PRODUCTS-COMP/OPAGG $2000000 $ OTHER: A AUTOMOBILE LIABILITY 46UENOL5276 9/1/2020 9/112021 EOMBINEeD SINGLE LIMIT $1000000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOSONLY AUTOS IX Per accident ( X BODILY INJURY $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ X $ Call$1,000 X comp $1.000 A X UMBRELLA LIAB X OCCUR 46XHUOL5274 9/1/2020 9/1/2021 EACH OCCURRENCE $10000000 AGGREGATE $10000000 EXCESS LIAB CLAIMSMADE DIED I X( I RETENTION$ nnnn $ 1 C WORKERS COMPENSATIN AND EMPLOYERS'LABILITY YIN ANYPROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBEREXCLUDEOT N/A 46WEOL6H1G 971/2020 911/2021 X J STATUTE I I ERH E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1000000 (Mandatory in NH) If yes, describe under E.L.-DISEASE- POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS below A S A Hired Car Physical Dam: $60,000 Employee Thell Valuable Papers 46UENOL5276 822415D8 46UUNOL5275 911/2020 9/1/2020 9/1/2020 9/112021 911/2021 9/112021 Hired PC Comp/COII Employee Theft Valuable Papers Ded $1,000/$1,000 Limit:$1,000,000 Limit: $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Additional Insured form #HG0001 edition 09/16 appplies to the General Liability policy. Waiver of subrogation form #HG0001 edition 09/16 applies to the General Liability policy. Primary & Non -Contributory General Liability form #HG0001 edition 09/16. Additional Insured form #HA9916 edition 03112 applies to the Automobile Liability policy. Waiver of subrogation form #HA9916 edition 03/12 applies to the Automobile Liability policy. Primary & Non -Contributory Auto Liability form #HA9916 edition 03/12. See Attached... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92702 ,r WekManag�mentDMs[on a �P REVIEwED&APPROVaDBY: ©1988-2015 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 4iMw