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Francine R. Digitally Hgned by FrandneR Yllareal Villarpal Dats:202202.24111941 A� o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMID2) 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(ies) must 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 Wood Gutmann &Bogart Insurance Brokers 15901 Red Hill Ave., Suite 100 CONTACT NAMEMichael Train : PHONE FAX 714-824-8384 a/c N0:714-573-1770 aooaless: mtran@wgbib.com Tustin CA 92780 INSURERS AFFORDING COVERAGE NAIC # INSURERA: State Compensation Ins Fund 35076 Ucens : 0679263 INSURED NATIO14 National Safety Services, Inc. 9121 Atlanta Ave Unit #732 INSURER B: CRUM & FORSTER SPECIALTY INS CO 44520 INSURERC: NATIONWIDE MUT INS CO 23787 INSURER D: Huntington Beach CA 92646 NBURER E: �E] INSURER F : COVERAGES CERTIFICATE NUMBER: 1501915933 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. INSR LTR rypE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFT MMIDDe"yYYI POLICY EXP fMMfDD1YYYY1LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EPK138577 V112022 21112023 EACH OCCURRENCE $LCOD000 DAMAGEf RENTED PREMISESSEa occurrence $50,000 MED EXP(Any one person) $5,000 PERSONAL &ADV INJURY $1,000.000 AGGREGATE LIMIT APPLIES PER: [ X ] GENERALAGGREGATE $2,000.000 GEN'L POLICY JECOT LOC PRODUCTS -COMP/OP AGG $2,000,000 I Deductible $5,000 OTHER: C AUTOMOBILE LIABILITY ACPBA3029635948 2I1/2022 V112023 COMBINED SINGLE LIMB Ea accident) $1 000000 BODILY INJURY (Per person) $ X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident)$ X HIRED AUTOS X AOOTNOOWNED PROPERTYDAMAGE $ B UMBRELLA LIAR X OCCUR EFX119725 W1n022 211U2023 EACH OCCURRENCE $1000.000 AGGREGATE $1000.000 X EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERTLIABILITY YIN 91240BO 2/4/2022 2/4/2023 X STATUTE I ERH E.L. EACH ACCIDENT $1,000.000 ANY PROPRIETOMPARTNERIEXECUnVE OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYE $Included (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $Included B Professional Liability EPK138577 2/1/2022 2/1/2023 $1,000,000 Limit $5,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of Santa Ana, its officers, officials, employees, and volunteers are named as additional insured on the General Liability per attached EN0351 0217 & EN0350 0217 as required by written contract subject to the terms and conditions of the policy. Primary and Nan -Contributory applies on the General Liability per attached EN0348 0217. Waiver of Subrogation applies to the General Liability per attached EN0349 0217. 30-Day Notice of Cancellation (other than non -pay) applies per attached EN0136-0211 THIS CERTIFICATE SUPERCEDES ANY PREVIOUSLY ISSUED. CERTIFICATE HOLDER City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i ©1988-2014 ACORD CI ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD RiskMelagernent Diyisi0n REVIEWED & APPROV®Br. Risk Management Analyst