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Francine R. Digitally signed by Francine R. Villareal \/ilh ro of Date 2022,01 413:a2:00 AC"REIr CERTIFICATE OF LIABILITY INSURANCE DA MIDD/YYYY) 11/29/2021 THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE RTIFI E 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 have ADDITIONAL INSURED provisions or 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 Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA 520 Madison Avenue 32nd Floor CONTACT NAME PHONE FAX c (888) 202-3007 AIc No): E-MAIL contact@hiscox.com ADDRESS: _INSURERIS) AFFORDING COVERAGE NAIC# New York, New York 10022 INSURERA: Hiscox Insurance Company Inc 10200 INSURED STRAIGHTLINE COMMUNICATIONS INSURER B : 14930 Greenleaf Street INSURER C: INSURER D: Sherman Oaks, CA 91403 NSURER E: INSURER F : f Ra1 la ter Ali 211 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 TYPE OF INSURANCE AD°L SUBR POLICYNUMBER MMIOCY/YEYFYY MW DY/YYXYI' LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAG RENTE CLAIMS -MADE OCCUR PREMISES Ea occurrence) $ 100,000 MED EXP (My one person) $ 5,000 A Y Y P100.042.462.8 01112/2022 01/12/2023 PERSONAL &ADV INJURY s 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X O- O- POLICY ❑ JECTPR LOC PRODUCTS-COMP/OP AGG s SIT Gen. Agg. OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I RETENTION$ IS WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANYPROPRIETOMPARTNEWEXECUTIVE OFFICERIMEMBEREXCWDEDY NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, describe under EL.DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS below A Professional Liability Y Y P100.042.069.8 01/12/2022 01/12/2023 Each Claim:$1,000,000 Aggregate: $ 2,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General and Professional Liability per the attached endorsements as IS quired by written contract. Insurance Primary and Non-contributory. Waiver of Subrogation applies... 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions. City of Santa Ana, Risk Management Division 20 Civic Center Plaza, 41h 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 ©1988-2015 AC, ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Ride Management Diylefem p rrIA R��EVIEWED&APPR�ffO�V/®BY: s "• r'"w D. VK..d Risk Management Analyst