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<br />Tort Pierson Wira2n22,000814:4L04
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<br />SCOTFAZ-01
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />MCCOVIANA
<br />A E(MMIODE
<br />DATE (MMIO0DfYYYY) 5118/22
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such. endorsements .
<br />PRODUCER License # OE67768
<br />IDA Insurance Services
<br />4370 La Jolla Village Drive
<br />Suite 600
<br />San Diego, CA 92122
<br />NC ACT All Smith
<br />PHONE
<br />ac, Ne, Eat:
<br />FAX
<br />619) 788-5795 50206 ac, No: 619 574.6288
<br />EMAIL AII.Smith@ioausa.com
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC a
<br />INSURER A: RLI Insurance Company
<br />13056
<br />INSURED _
<br />Scott Fazekas & Associates, Inc,
<br />9 Corporate Park Drive
<br />Irvine, CA 92606
<br />INSURER B: Continental CasualtyCompany
<br />20443
<br />INSURER C:
<br />INSURER D:
<br />INSURER E:
<br />INSURER F :
<br />COVERAGES . CERTIFICATE NUMBER: REVISION NUMBER: 1
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />TYPE OF INSURANCE
<br />ADDL
<br />Jm
<br />BUBR
<br />AM
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICYEXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ❑X OCCUR
<br />.X
<br />-
<br />PSBOOD3027
<br />61512022
<br />6/512023
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />1,000,000
<br />X
<br />MED EXP An one rsan
<br />Cont Llab/Sev of Int
<br />10,000
<br />PERSONALS ADV INJURY
<br />S 11000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY ❑X JECT LOC
<br />GENERAL AGGREGATE
<br />E 2,000,000
<br />GEN'L
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,006
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />16 1,000,00
<br />X
<br />X
<br />ANY AUTO
<br />OWNED
<br />OWNED AUTOSSCHEDULED
<br />ONLY AUTOS
<br />AUTOS ONLY X AUTOS ONNLV
<br />A&C.'Owned
<br />as
<br />PS00003027
<br />6/512022
<br />6/5/2023
<br />BODILY INJURY Per rew
<br />E
<br />BODILY INJURY Per accident
<br />pp
<br />PPe�erE.rlRdenl AMAGE
<br />$
<br />A
<br />X
<br />LUIB
<br />E%CESS LIAB
<br />I X
<br />OCCUR
<br />CLAIMS -MADE
<br />PSE0001119
<br />615/2022
<br />6/5I2023
<br />EACH OCCURRENCE
<br />2,000,000
<br />AGGREGATE
<br />$ 2,000,000
<br />DED I X I RETENTION$ 0
<br />A
<br />B
<br />B
<br />WORKERS COMPENSATIONOTH-
<br />ANDEMPLOYERS•LIABIDTYIN
<br />OFICEYPSW0001945
<br />WMEIM90EREXCLUOED7 ECUTIVE Y❑
<br />M 1 t1N
<br />I amatory
<br />oyes, describe under
<br />DESCRIPTION OF OPERATIONS balm
<br />Professional Liab.
<br />Ded.: $20k Per Claim
<br />NIA
<br />-
<br />MCH288352513
<br />MCH288352513
<br />6l512022
<br />615/2022
<br />61512022
<br />6I5/2023
<br />615/2023
<br />61512023
<br />E.L. EACH ACCIDENT
<br />§ 1,000,000
<br />E.L. DISEASE -FA EMPL YE
<br />$ 1,000,000
<br />E.L. DISEASE. POLICY LIMIT
<br />Per Claim
<br />Aggregate
<br />1 1, 1,000,000
<br />2,000,000
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional RemarksSchedule, may be attached if more apace Is required)
<br />Re: All Operations
<br />City of Santa Ana, Its officers, employees, volunteers, representatives and agents are Additional Insureds with respect to General Liability per the attached
<br />endorsement as required by written contract.
<br />30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions..
<br />City of Santa Ana
<br />Attn: Risk Management Divisor;
<br />20 Civic Center Plaza, 4th Floor
<br />SHOULD ANY OF THE ABOVE DESCRIBEfTHE EXPIRATION DATE THEREOF,
<br />ACCORDANCE WITH THE POLICY PROVI$ RWrManga,mioM '
<br />RtinEv,Fn 6 Awxw®Rr.
<br />'tYil %au
<br />AUTHORIZED REPRESENTATIVE
<br />-r II "' RiskM u9em Uni lP sre
<br />ACORD 25 (2016103) 01988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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