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�1 A`CO'RO CERTIFICATE OF LIABILITY INSURANCE v DATE(MMIDDI(YYY) 03/1612022 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(les) 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 endorsements . PRODUCER Bettis Insurance Services, Inc PO Box 2816 San Pedro CA 90731-0197 CONTACT Kathleen McDermott E FAX PNONE . (310)521- 480 ,c .(310)521-0111 E-MAIL kalhleen@bettisins.com INSURE COVERAGE NAICd INSURER A:State Compensation Insurance Fund 35076 INSURED INSURERS, INSURER C : Shakespeare By The Sea INSURERD: 777 South Centre Streeet San Pedro CA 90731- INSURERS: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICCY EFF POLICY MMIOD EXP YYYI LIMITS COMMERCIALGENERAL LIABILITY CLAIMS -MADE OCCUR Not Applicable EACH OCCURRENCE $ DAMAGE TO RENTED MEDEXP An one arson S $ PERSONAL &ADV INJURY It GEN'L AGGR EGATE LIMIT APPLIES PER: POLICY M JECCT LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGO $ AUTOMOBILE LIABILITY ANYAUTO OVrNEO SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY ALTOS ONLY Not Applicable COMBINEDSINGLE LIMIT BODILY INJURY(Perperson) $ $ BODILY INJURY(P. accident) $ PROPERTY DAMAGE (Per eneldn,J) $ E UMBRELLA LIAR I EXCESS LIAB H OCCUR CLAIMS-WDE Not Applicable EACH OCCURRENCE $ AGGREGATE $ RETENTION $ A WORKERS COMPENSATION AND'EMPLOYERS' LIAMUTY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTIONF OPERATIONS below NIA 909171E-2022 3/07/2022 3/07/2023 X I PER I I OTH- E.L EACH ACCIDENT $ 1.x'Iti ';UUIY E.L. DISEASE-EAEMPLOYEE $ 1,000,000 E.L. DISEASE-POUCY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD ID1, Additlonal Remarhe Sohadule, may be attaehed if more epaoe Is req.lred) This certificate is issued as proof of workers compensation coverage only. CERTIFICATE HOLDER CANCELLATION AI 000822 City of Santa Ana Attn: Risk Management 20 Civic Center Plaza Santa Ana ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CA 92701- I AUTHORIZED REPRESENTATIVE @ 11188-2015 ACORD The ACORD name and logo are registered marks of ACORD RIM M»lAgOnn¢TLUMBIDrt -g REVIEWED&APPROVEDBY: A4V Aewufo ®' Risk Management Specialist