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vlyltarly nlgiICU <br />� CERTIFICATE OF LIABILITY INS6WI19 by An IeDATEE(2MlWDDrrYY) <br />312022 <br />r <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS N ('� p)7 �r7�L� E THIS <br />}��p <br />FVKT1e1Utlf''FYIC� dSr� <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALT P HCIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE P:SUING11113S71IE ).( T1�RIZED <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 endorsement(s). <br />PRODUCER <br />Arthur J. Gallagher & Co. <br />Insurance Brokers of CA Inc. License #0726293 <br />18201 Von Korman Ave Suite 200 <br />Irvine CA92612 <br />CONTACT <br />NAME: <br />PHONE ggg_34s-s800 aL Nc:949-3a9-ss00 <br />E-MAILEXIII <br />ADDRESS: <br />INSURERS AFFORDING COVE RAGE <br />NAIC# <br />INSURERA: Nationwide Mutual Insurance Company <br />23787 <br />INSURED SUPEPRW4 <br />Superior Property Services, Inc. <br />INSURER B: Depositors Insurance Company <br />42587 <br />9129 Perkins Street <br />INSURER C: <br />INSURER D: <br />Pico Rivera CA 90660 <br />INSURER E <br />NSURERP: <br />COVERAGES CERTIFICATE NUMBER: 1237103010 REVISION NUMBER - <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 />LTR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />POLICYNUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE FxI OCCUR <br />V <br />Y <br />ACP3049630195 <br />6/22/2022 <br />6/22/2023 <br />EACH OCCURRENCE <br />$1,000,000 <br />A AGETO RENTED <br />PREMISES Ea occurrence <br />$100.000 <br />MED EXP (Any one person) <br />$ 5,000 <br />PERSONAL S ADV INJURY <br />$1,000,000 <br />GEN-L <br />X <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY X JECTPRO- <br />LOC <br />OTHER: <br />GENERALAGGREGATE <br />$2,000,000 <br />PRODUCTS -COMP/OP AGO <br />$2,000,000 <br />$ <br />B <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />Y <br />Y <br />ACP3049630195 <br />6/22/2022 <br />6/22/2023 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1,000,000 <br />BODILY I NJURY(Per person) <br />$ <br />n <br />Per accident <br />BODILY INJURY ( 1 <br />$ <br />PROPERTY D AMAGE E$ <br />Per accident <br />UMBRELLA LIAR <br />EXCESS LIAa <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED I I RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YI N <br />ANYPROPRIETORIPARTNER/EXECUTIVE <br />OFFICER/MEMBEREXCWDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />V <br />ACP3049630195 <br />6/22/2022 <br />6/22/2023 <br />XI BPER <br />TATUTE ERH <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />F.L. DISEASE - EA EMPLOYEE <br />$1,000,ODO <br />E.L. DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />RE: Agreement Number: N-2020-082 I Project: Touch up mural, pressure wash, cover artwork with anti -graffiti coating. <br />The City of Santa Ana, its officers, officials, employees, agents, volunteers, Entity and representatives are additional insureds when you have agreed, in a <br />written contract or written agreement, only with respects to the General Liability per business liability coverage forms CG 20 33 04 13, CG 20 37 04 13. Primary <br />and non-contributory wording is included as per form CG 20 01 04 13. Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation. <br />CERTIFICATE <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />20 Civic Center Plaza, 4th floor <br />Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE <br />USA s�,j �.� Riak irl>magnnott Divislnn <br />�(���.��\� REmeAM & APPROVED BY: <br />© 1988-2015 ACORD 4ni11lJiJ;.' Xju Arum, <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD :'' Risk Management Spcnakst <br />