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RAA U g 1e <br />DATE (MMIDOIYYYYI <br />CERTIFICATE OF LIABILITY INSU A b Angl,zDzz <br />IRL =D BY THE POLICIES <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RI TS P N T E�(^CE';II�/ ER. T <br />Td��IRI' INSL®.�Ql: AUTHORIZED <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER T <br />V <br />BELOW. THIS CERTIFICATE OF INASN RTHE CERT FSCATE HOLDER.NOT UTE A CONTRACT BE E fis`u�I rsed. <br />REPRESENTATIVE OR PRODUCER, the polic les must have A I�AL INSUr.ED pro rA <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, y( )Certain polici qui•a r,i endorsen6Mtj1O <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, — <br />this certificate does not confer rights to the certificate holder in lieu of suchCT Sabrina endorsement(s)Gariba' <br />NAME: NA:212-9947047 <br />PRODUCER PHONE 212-994-7100 <br />Arthur J. Gallagher Risk Management Services, Inc. E-01AI1. <br />250 Park Avenue, 5th Floor ADIIA11. Sabrina Gaiba a .corn NAICM <br />New York NY 10177 INSURERS AFFORDING COVERAGE 23043 <br />INSURED <br />Rai <br />a oLa Track <br />Road <br />LLC <br />O <br />Unit B <br />Santa Fe Springs, CA 90670 <br />DVERAGES t.trc nrn.,+� •- THIS <br />- <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED T <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />IMS- <br />POLICY EFF POLICY FXP LIMITS <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />LIMITS SHOWN MAY HAVE BEEN REIN PmNvoo�mYY <br />3R POLICY NUMBER 12023 EACH OCCURRENCE $ 5,000 000 <br />TYPEOFINSURANCE IN D WV TB5621095327032 <br />DAM S1,000,000 <br />CLAIMS -MADE Ifl OCCUR <br />Incl. Cont.I iab <br />50' RR Exl. Del <br />'L AGGREGATE LIMIT APPLIES PER: <br />POLICY II JECT � LOC <br />q AUTOMOBILELIAaILITY <br />X ANY AUTO <br />OWNED <br />AUTOS <br />AUTOS ONLY <br />HIRED <br />AUTOSONLV <br />UMSRELLALIAB <br />EXCESS LIAR <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS ONLY <br />OCCUR <br />COMBINED SINGLE LIMIT $2,000.000 <br />4/1/2022 4/11202a" Ea accMent <br />AS5-621-095327-042 BODILY IN, <br />(Per person) S <br />BODILY INJURY (Per accitlenq S <br />PronPERTY DAMAGE S <br />WA2-62D-095327-012 4/1/1022 022 I 411/2023 <br />2023 <br />WA2-621-095327-022 <br />ri y volunteers and representatives are included <br />oESCRIPTION OF OPERATIONS <br />0 T5ast LOCATIONS <br />to Ana Boulevard CLESrd C RD 101, A The Ci Re of SantaeAna its officers, employees, agents¢ <br />Re: Suite 106, <br />sAdditional bed unseo a Gene ell LiabilitynoytrPolicy here required by written contract.blhty where required by wrliten contract. Cross LlabilitylSeverability o <br />;ERTIFICATE HOLOttt <br />SHOULD EXPIRY ION ATE THEREOF, <br />NOOCEI WILL CANCELLED <br />DELIVERED BEFORE <br />IN <br />THE EXPIRATION DATE THEREOF, <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />The City of Santa Ana <br />Attention. Executive Director of Public Works Agcy AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza (M-21) < < ",.._ Rhk DDivisionS <br />Santa Ana CA 92701 .�".� , REvltwED6APPRwED BY.' <br />© J988-2015 ACORD A Acu'k�o <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management Spedallst <br />