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<br />aC4006/20/2024 1 " CERTIFICATE OF LIABILITY INSURANCE DATE(M/2024
<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 endorsement(s).
<br />PRODUCER CONTACT Willis Towers Watson Certificate Center
<br />NAME:
<br />Willis Towers Watson Northeast, Inc.
<br />PHO No Eat 1- 77-945-7378 A/C No: 1-888-467-2378
<br />c/o 26 Century Blvd
<br />P.O. Box 305191 t
<br />Nashville, TN ri 372305191 INSj1RER(S)AFFORDING COVERAGE NAIC#
<br />N IR flipce America Inc 24554
<br />INSURED INS RERB: Tra ers Property Casualty Company of Ame 25674
<br />Fieldturf USA Inc
<br />c/o Sports Division velid
<br />Insurance Company 26387
<br />Tarkett Inc. F
<br />'IRERD:
<br />7445 Cote-de-Liesse Road, S t 20c e v e O IINSURERt le
<br />Montreal, QC H4T 1G2 CAN
<br />Da
<br />CnVFRAGFR CFRTIFICATF NIIMRFR: V ,3940876 n n, C n, n n n 17AV%"NIIMRFR
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE I ,STr J BELOW HA PO INAAAD NWIVABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TF,JM jR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE N9 ,RANCE 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 />INSD
<br />SUBR
<br />WVD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE � OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 500,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />A
<br />y
<br />y
<br />US00010327LI24A
<br />05/01/2024
<br />05/01/2025
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />POLICY � PRO -
<br />POLICY ❑ LOC
<br />PRODUCTS - COMP/OPAGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 5,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />y
<br />TC2JCAP-823K312A-TIL-24
<br />05/01/2024
<br />05/01/2025
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />UMBRELLA LAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBEREXCLUDED? No
<br />(Mandatory in NH)
<br />N/A
<br />y
<br />UB-8P793534-24-51-K
<br />05/01/2024
<br />05/01/2025
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />B
<br />Workers Compensation &
<br />y
<br />UB-8P760619-24-51-R
<br />05/01/2024
<br />05/01/2025
<br />E.L. Each Accident
<br />$1,000,000
<br />Employer's Liability
<br />E.L. Disease-Pol Lmt
<br />$1,000,000
<br />Work Comp - Per Statute
<br />E.L. Disease -Each Em
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />This Voids and Replaces Previously Issued Certificate Dated 05/02/2024 WITH ID: W33470938.
<br />WC Policies:
<br />Policy # UB-8P793534-24-51-K - covers all other states.
<br />Policy # UB-8P760619-24-51-R - covers AZ, MA, WI only.
<br />SEE ATTACHED
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PRC
<br />oR, RAMougmumtDMslan
<br />City of Santa Ana gi
<br />20 Civic Center Plaza (M-30) AUTHORIZED REPRESENTATIVE
<br />REVIEWED&PaPPROVmBY:
<br />P.O Box 1988.a� A��
<br />Santa Ana, CA 92702-1988 — Risk Management Specialist
<br />© 1988-2016 ACORD
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />SR ID: 26046662 BATCH: 3510485
<br />
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