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Francine R. Digitally s,imcd by Fnindre
<br />P.Villareal
<br />no \/ilhrool Date: 2022.02.0911:07:45
<br />'4 CERTIFICATE OF LIABILITY INSURANCE l save z/4/2022 ar2D2z
<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(tes) 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 />AHT Insurance
<br />20 S. King Street
<br />Leesburg VA 20175
<br />CONTACT EXPRESS
<br />NAME
<br />PHONE
<br />833-287-9378 LPJC,FAX No:
<br />AUoR1Ess: express@ahtins.com
<br />INSURER3 AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A: ACE Fire Underwrltem Insurance Company
<br />20702
<br />INSURED SENSLLC-02
<br />SenseMakers, LLC
<br />INSURERS: Hartford Casualty Insurance Company29424
<br />INSURERC: United States Liability Insurance Company
<br />25895
<br />2401 East Katella Avenue, Suite 610
<br />Anaheim CA 92806
<br />INSURERD:
<br />INSURER E :
<br />INSURER F
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR
<br />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
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INBR
<br />LTR
<br />TYPE OF INSURANCE
<br />AOOL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM DD/YYYY
<br />POLICY EXP
<br />MM/DDNYYYJ
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERALLIABILITY
<br />Y
<br />V
<br />D9663786A
<br />11/28/2021
<br />11/28/2022
<br />EACH OCCURRENCE
<br />-RENTED
<br />$1,000,000
<br />CLAIMS-MADEIT] OCCUR
<br />DAMAGET
<br />PREMISES Ea ccunami
<br />$1,000,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL B ADV INJURY
<br />$1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />0 PRO-
<br />❑
<br />GENERA -AGGREGATE
<br />$2,000,000
<br />GEN'L
<br />X
<br />PRODUCTS - COMPIOP AGG
<br />$2,000,000
<br />POLICY JECT LOC
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />V
<br />V
<br />D9663786A
<br />71/28/2027
<br />11/26/2022
<br />OMBIINdE�D SINGLE LIMITFai
<br />$1,000,000
<br />ANY AUTO
<br />BODILY INJURY (Per person)
<br />$
<br />OWNED SCHEDULED
<br />BODILY INJURY (Per accident)
<br />$
<br />AUTOS ONLY AUTOS
<br />X
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />Y DAMAGE PERT
<br />Per PROPERTY
<br />accident)
<br />$
<br />A
<br />X
<br />UMBRELLA LIAS
<br />X
<br />OCCUR
<br />D96637871
<br />11/28/2021
<br />11/28/2022
<br />EACHOCCURRENCE
<br />$2,000,000
<br />AGGREGATE
<br />$2,000,000
<br />EXCESS LIAS
<br />CLAIMS -MADE
<br />DIED I X RETENTIONS
<br />B
<br />WORKERS COMPENSATION
<br />Y
<br />42WECAKBNRL
<br />5/9/2021
<br />5/9/2022
<br />X STATUTE ERH
<br />$
<br />AND EMPLOYERS' LIABILITY V / N
<br />E.L. EACH ACCIDENT
<br />$11000,000
<br />ANYPROPRIETORIPARTNER/EXECUTIVE
<br />OF FICEWMEMBEREXCLUDED?
<br />NIA
<br />(Mandatory in H)
<br />es,describe If yea. under
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />E.L. DISEASE- POLICY LIMIT
<br />$1.000,000
<br />DESCRIPTION OF OPERATIONS he.
<br />C
<br />Professional liability
<br />SP 1572206B
<br />11/28/2021
<br />11/28/2022
<br />Each Claim
<br />$2,000,000
<br />Aggregate
<br />$2,000,000
<br />DESCMPTIONOFOPERATIONSILOCATIONSIVEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana, its officers, employees, agents and representatives are additional insured with respect to general liability per attached endorsements as
<br />required by written contract. Insurance is primary and non-contributory. Wavier of Subrogation applied to workers compensation.
<br />CER
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />The City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th Floor AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701
<br />. REVIEWmtN 6APPRED Bv:
<br />©1988.2015 ACORD C 9! ':: e, F4A4, :e.a J. V�t
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD t='' Risk Management Analyst
<br />
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