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Francine R. Digitally signed by Francine R,
<br />Villa rflol Villareal
<br />ACO1....� P ' 2 ® CERTIFICATE OF LIABILITY INSURANCE _ n/2ozz
<br />DATEYYYY)
<br />1/26/20/2021
<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 Lockton Insurance Brokers, LLC
<br />777 S. Figueroa Street, 52nd FL
<br />CA License#OF15767
<br />Los Angeles CA 90017
<br />CONTACT
<br />NAME;
<br />PHONE FAX
<br />Ea AIC No:
<br />E-MAILo
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICIs
<br />(213)689-0065 -
<br />INSURER A: Crum & Forster Specialty Insurance CO
<br />44520
<br />INSURED Rlncon Consultants, Inc.
<br />1462718 160 N. Ashwood Ave.
<br />INSURER B : Hartford Fire Insurance Company
<br />19682
<br />INSURER C : Starstone National Insurance Company
<br />25496
<br />INSURER D
<br />Ventura CA 93003
<br />NSURER E
<br />INSURER F :
<br />COVERAGES RINCO01 CERTIFICATE NUMBER: 16059509 REVISION NUMBER: XXXxXXx
<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 />INTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />D
<br />SUER
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DDIYYYY
<br />POLICY EXP
<br />MMVDDPi
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE I X1 OCCUR
<br />Y
<br />Y
<br />8PK-133853
<br />2/1/2021
<br />2/1/2023
<br />EACH OCCURRENCE
<br />$ 3 OOO QQO
<br />TED
<br />PREMISES( Ea occurrence)
<br />$ 100,000
<br />X
<br />MED EXP (Any one person)
<br />s 10,000
<br />SIR: $50 000
<br />P&I
<br />LBADVINJURY
<br />$ 3,000,000
<br />X
<br />AGGREGATE LIMIT APPLIES PER:
<br />PRO- LOC
<br />AGGREGATE
<br />$4000000POLICY
<br />GEN'L
<br />S-COMP/OP AEG
<br />$ 4000 Q00ECTOTHER:
<br />$B
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />72UENOL5481
<br />2/1/2021
<br />2/1/2022
<br />WGENEMLAGGREGATEs
<br />SINGLE LIMIT
<br />$nt 1 QQQ QQQX
<br />JURY (Per person)
<br />$ XXXXXXXOWNED
<br />ANVAUTO
<br />SCHEDULED
<br />ONLY AUTOS
<br />AUTOS ONLY X AHIRED �TOS ONEV
<br />JURY Per accltlent
<br />( )X
<br />$ XXXXXXXAUTOS
<br />n DAMAGE
<br />$ XXXXr CXX
<br />$XXXXXXX
<br />A
<br />UMBRELLA LIAB
<br />N
<br />OCCUR
<br />N
<br />N
<br />EFX-116867
<br />2/1/2021
<br />2/1/2022
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5 000 000
<br />X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION$ 10000
<br />$ XXXXXXX
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOWPARTNEWEXECUTIVE
<br />OFFICEWMEMBER EXCLUDED? ❑N
<br />NIA
<br />Y
<br />T11210321
<br />2/1/2021
<br />2/1/2022
<br />X SPER
<br />TATUTE EftH
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory In NH)
<br />[Yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Contractors Pollution Liab
<br />N
<br />N
<br />BPK-133853
<br />2/1/2021
<br />2/1/2023
<br />Limit $3,000,000/$4,000,000
<br />E&O Liab.-Claims Made
<br />Limit $3,000,000/$4,000,000
<br />Ream Date: 12/9/1994
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101, Additional Remarks Schedule, may he attached if more space Is required)
<br />THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FORTHIS HOLDER, APPLICABLE To THE CARRIERS LISTED AND THE POLICY'TERM(S) REFERENCED.
<br />Cyber Liability: Carrier: HDI Specialty Insurance Company, Policy No. Renewal Policy NSCTRD2590380000, Policy Term: 2/t/2021-2/1/2022, Limit: $5,000,000 SIR: $10,000.
<br />The City of Santa Ana and Community Development Agency and their officers, employees, agents and voluateers are an Additional Insured to the extent provided by the policy language
<br />or endorsement issued or approved by the insurance carrier. Waiver of Subrogation applies per attached endorsement(s) or policy language. Insurance provided to Additional Insureds)
<br />is primary and non-contributory as per the attached endorsement or policy language, Excess policy follows General Liability, Auto Liability and Employers Liability form. Notice of
<br />Cancellation applies per the applicable policy language or endorsements.
<br />16059509
<br />City of Santa Ana
<br />Risk Management Divison
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana CA 92701
<br />ACORD 25 (2016103)
<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
<br />1 f KIhRMRIla�a111CRt UtMs101t
<br />" Q10"_
<br />REVIEWED&APPROV@BY.,
<br />©1 a6-201 Co Dc F4 ,,t. 04
<br />The ACORD name and logo are registered marks of ACORD Ruk Managementnnalys[
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