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signed <br />Tori Pierson Wtt'ea21021.10.11308:15:25e0700' <br />SERVICE FI JEANA <br />,d►coRO CERTIFICATE OF LIABILITY INSURANCE <br />DAT/13/2D/Y <br />1 <br />813/2021 <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 <br />CONTACT <br />NAME: <br />(A/CC,Nro, Ext): (949) 553-9800 FAX No):(949) 553-0670 <br />The Wooditch Company Insurance Services, Inc. <br />1 Park Plaza, Suite 400 <br />Irvine, CA 92614 <br />A DD E-MAIL <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURERA:United Specialty Insurance Co. <br />12537 <br />INSURED <br />INSURER B : <br />INSURER C7 <br />Service First <br />INSURER 7 <br />2510 North Grand Ave, Ste. 110 <br />Santa Ana, CA 92705 <br />INSURER E <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 <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 />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE X OCCUR <br />X <br />ATN2118412 <br />8/1/2021 <br />$/1/2022 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />100,000 <br />$ <br />MED EXP (Any oneperson) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENT <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />POLICY X 71 PEA LOC <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY Perperson) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY Per accident <br />$ <br />PROPERTY DAMAGE <br />ccident <br />Per accident) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />PER OTH- <br />STATUTE ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT <br />$ <br />OFFICER/MEMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />N / A <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: All operations performed by the Named Insured during the current policy period. glaip <br />City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are included as Additional Insureds as respects General <br />Liability per attached endorsement. <br />This Insurance shall apply as Primary and Non -Contributory per attached endorsement. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <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 PROM—— <br />Rie(r Mowganenf Division <br />AUTHORIZED REPRESENTATIVE 4 ' -. NEVIEwEo & APPROVED BY: <br />%mri Pe`err ww <br />Risk Management Clerical Aisle <br />ACORD 25 (2016/03) © 1988-2015 ACORD CC6r y <br />The ACORD name and logo are registered marks of ACORD <br />