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Digitally signed by FranNre If <br />Francine R. Villarealwllareel <br />I 1 tAND800 <br />a <br />,4�R0 CERTIFICATE OF LIABILITY INSURANCE <br />DA03/2412021Y, <br />03/24I2021 <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 endorsements . <br />PRODUCER 310-542.4600 <br />High Ground Insurance Services <br />Crenshaw Blvd, #304 <br />Torrance, <br />Torrance, r 90501 <br />Christopher Cordill <br />cWACT Christopher Cordill <br />AICNN, Extp 310.542-4600 ac, No 310-542-8400 <br />OpA1L ,ccor I unite agencies.com <br />INSUREFUSI AFFORDING COVERAGE <br />NAIL # <br />INSURER A: THE HARTFORD <br />11000 <br />L SUS,. cape West Mgmt Svcs, Inc. <br />INSURERe:Technology Insurance Co. <br />42376 <br />INSURER C: <br />1234 North Blue Gum Street <br />Anaheim, CA 92806 <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />oovrornu uux <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 />INBR <br />TypE OF INSURANCE <br />DDL <br />NRD <br />DER <br />usury <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXPIm <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />X <br />72UUNOK7437 <br />04/01/2021 <br />04/01/2022 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTE PREMISES (Ea en <br />$ 300,000 <br />MED EXP (Any oneperson) <br />$ 5,000 <br />PERSONAL S ADV INJURY <br />$ 1,000,000 <br />GEN'L <br />AGGREGATE LIMITAPPLIES PER: <br />POLICY El ma DLOC <br />GENERAL AGGREGATE <br />2,000,0.00 <br />PRODUCTS - COMP/OP AGO <br />21000,000 <br />OTHER: <br />Emp Ben. <br />0 <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />AUTOS ONLY X AUUTOS ONLY <br />72UUNOK7437 <br />04/01/2021 <br />04/01/2022 <br />COMBINED SINGLE LIMIT <br />$ 1,000,000 <br />$ <br />BODILY INJURY Per arson <br />BODILY INJURY Peraccauenl <br />$ <br />X <br />ParOa¢ltlent AMAGEis <br />A <br />X <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />72HHUOK7438 <br />04/01/2021 <br />04/01/2022 <br />EACH OCCURRENCE <br />§ 2,000,000 <br />AGGREGATE <br />$ 2,000,000 <br />DEDT1 RETENTION$ <br />B <br />WORKERS <br />ND EMPLOY EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNEMEXECUTIVE YIN <br />OFFICERMIEMBER EXCLUDED? �Y <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />X <br />TWC3917807 <br />10/11/2020 <br />10/11/2021 <br />STA X Ui ETA <br />E.L. EACH ACCIDENT <br />1,000,000 <br />E.L. DISEASE -EA EMPLOYE <br />$ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Project: Right of Way and Median Landscape Maintenance Services RFP#19-016 <br />`•` See Holder Notes attached for additional information "'" <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <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 REPRESENTATIVE <br />� Al/ <br />ACORD 25 (2016103) ©1988-2015 ACORD C <br />The ACORD name and logo are registered marks of ACORD <br />RbkMolRganodDividon <br />c REmEWm&APPROVBDBY' <br />Fes, �r V lLw.:>c' <br />Risk Management Analyst <br />Is <br />