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<br />4tRO- CERTIFICATE OF LIABILITY IN 1y1•pp�Ayr}�y'f^y
<br />�l.0
<br />I" Date: 2022.08.15
<br />DATE DD
<br />V CU_
<br />8
<br />22)
<br />09/27/2022
<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 ORNEGATIVELYAMEND, 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 endorsement(s).
<br />PRODUCER
<br />Bannister & Associates Insurance Agency
<br />CA License #0691071
<br />Street untingtngton Beach CA 92698
<br />Huntington
<br />CONTACT
<br />NAME: Kerry M WakelPHONE
<br />INC, NO (719) 536-6066 71:aC No: (719) 536-9054
<br />ADDRESS: kerry@bai-ins.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />(NSURERA: Ohio SecurityInsurance company
<br />24082
<br />INSURED (949) 215-5539
<br />Barrios and Associate, LLC
<br />INSURER B: Philade hia Indemnity Ins. Co.
<br />18058
<br />INSURER C: American Fire and Casualty Co.
<br />24066
<br />dba Communications Lab
<br />701 E Chapman Avenue
<br />INSURERD:Axis Insurance Company
<br />37273
<br />INSURER E:
<br />Orange CA 92866
<br />INSURER F
<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 />ADDL
<br />O
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYYI
<br />POLICY EXP
<br />(MMIDD[YN`YYI
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />Y
<br />Y
<br />BKS (23) 56589875
<br />09 /O1/2022
<br />04/01/2023
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />PREMISESEaoccurrDAMAGE TO R fDence
<br />$ 500,000
<br />MED EXP (Any one person)
<br />$ 15, 000
<br />PERSONAL &AOV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO-
<br />JECT lxl LOG
<br />OTHER:
<br />GENERAL AGGREGATE
<br />$ 2 000,000
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />HAS (23) 56589875
<br />04/01/2022
<br />04/01/2023
<br />COMBINED ISINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per awident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />Tx
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS-MADE09/Ol/2022
<br />ESA (23) 56589875
<br />09/01/2023
<br />EACH OCCURRENCE
<br />$ 6,000,000
<br />AGGREGATE
<br />$ 6,000,000
<br />DED RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROPRIETOR/PARTNERIEXECUTIVE
<br />OFFICERIMEMBEREXCLUDED7
<br />(Mandatary In NH)
<br />It yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />XWS (23) 56589875
<br />04/01/2022
<br />04/01/2023
<br />_
<br />X STATUTE OER
<br />E.L. EACH ACCIDENT
<br />$ 1 000 000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />B
<br />Professional Liability
<br />PHSD1699192
<br />Deductible: $5,000/claim
<br />04/01/2022
<br />04/01/2023
<br />Limit (per
<br />claim):
<br />Limit (aggregate):
<br />$ 2,000, 000
<br />$ 4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />City of Santa Ana and Santa Ana Police Department, its officers, officials, employees, and
<br />volunteers are named as additional insureds (off -site and ongoing operations only) withrespectsgeneral liability policy limits. Primary and non-contributory wording applies with respects general o.
<br />liability policy limits. Waiver of subrogation applies with respects general liability policy
<br />limits.
<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 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702 i _ RiskMamsprenfDlWsEmt
<br />of s"a REVIEIC/ED&APPROVED Sr.
<br />©1988.2015 CORD & ) A4ft AOZV
<br />44
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />��""-�" RJsk ManagkmanESPedalist
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