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A� O' CERTIFICATE OF LIABILITY INSURANCE oszzMzoi2D"'"" 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 endorsements . PRODUCER CONTACT Paychex Insurance Agency Inc PAYCHEX INSURANCE AGENCY, INC. 150 SAWGRASS DRIVE PHONE 877-266-6850 FAX . 585-389-7426 EMAIL Certs@paychex.Com ROCHESTER, NY 14620 INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURERA: Sequoia Insurance Company 22985 INSURER B: PROUDCITY INC 750 GRAND AVE, APARTMENT 3G INSURER C: BROOKLYN, NY 11211 INSURER D: INSURER E: 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. NSR LTR TYPE OF INSURANCE DDLSUBR INSR D POLICY NUMBER POLICY EFF (MM/DDNYYY) POLICY EXP (MM/DDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY OCLAIMS-MADE�OCCUR DAMAGE TO RENTED $ $ MED UP (Any one person) PERSONAL&ADV INJURY $ GENERALAGGREGATE $ EN-L AGGREGATE LIMIT APPLIES PER: POLICY = PROJECT LOL PRODUCTS -COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO uLOWNED O SCHEDULED AUTOS AUTNUSWNEO HIRED AUTOS �ABTOS COMBINED SINGLE LIMIT (Ea accidenl) $ BODILYINJURY PerpBODILY INJURY $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE (Peraccident) $ $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CI -AIMS -MADE $ OED RETENTIONS WORKERS COMPENSATIONANO EMPLOYERS LIABILITY QWC1189075 Ot/15/2022 01/15/2023 X WLSTATU- OTH- E.L. EACH ACCIDENT $ 1,000,000.00 ANY PROPRIETOR/PARTNE WLXECUTIVE OFFICEWMEMBEREXCLUDED9 IMendflaq in NH) NN N/A EL.DISEASE -EA EMPLOYEE $ 1,000,000.00 E.L. DISEASE -POLICY LIMIT $ 1,000,000.00 Iryes,ducneeunder DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addilional Remarks Schedule, if more space is required) PJAMoMgenailDwant REVIEYIEDfi MPRW®BY: ' �!eui �cGE:z $toff-le:.t�na U Rol,Manager r. CERTIFICATE HOLDER CANCELLATION If City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE r lck� PSi cif ACORD 25 (2016/05) @1988.2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD