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Ac o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
<br /> `••----- 06/28/2024
<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 Lindsey Jamall
<br /> iAi1E:
<br /> The Liberty Company Insura Brokers • 'HON •(888)40 -396 • FAX
<br /> Lic#0D79653 _finN RNI1 �a Iy o�nIacor�I nc
<br /> 5955 De Soto Ave,Ste 25 INSURER(S)• AFFORDING COVERAGE NAIC#
<br /> Woodland Hills I eA 91367 I, uR S nti I ra o any 11000
<br /> INSURED ,is Z : a r s n t ce o cue v e d o 29424
<br /> Lance Soil&Lunghard LLP INSUF Q C: ^/JJJjjj 7 (x�203 N Brea B •Ste 203 INSLUID t f'�• L o 2 /, •o/ •O V
<br /> Brea A - ` si at RER F: ` L_.fL
<br /> COVERAGES _Wr• . AT'VAL .4!" C' ' 211 WA Mr • 1 Ut f IlENTSfill
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEL('N H .JE BEEN ISSUED 0 T Eft.:a-• D It, . D':OVE.7- HE-7 w•ERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CO'.OIT' iN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE A:r,RDED 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 AUUL SUI*t POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYYI_(MM/DD/YYYY) LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY 2,000,000
<br /> EACH OCCURRENCE s
<br /> X DAMAGE WR BlED
<br /> CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 1,000,000
<br /> MED EXP(Any one person) $ 10,000
<br /> A Y Y 57SBABM1263 10/12/2023 10/12/2024 PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> X POLICY PRO- II LOC PRODUCTS-COMP/OPAGG $ 4,000,000
<br /> JECT
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
<br /> (Ea accident)
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED Y Y 57SBABM1263 10/12/2023 10/12/2024 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> XHIRED N., NON-OWNED PROPERTY DAMAGE s
<br /> AUTOS ONLY _ AUTOS ONLY (Per accident)
<br /> $
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE s 1,000,000
<br /> A EXCESS LIAB CLAIMS-MADE 57SBABM1263 10/12/2023 10/12/2024 AGGREGATE $ 1,000,000
<br /> DED X RETENTION$ 10,000 $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY X STATUTE ER
<br /> Y/N
<br /> B ANY PROPRIETOR/PARTNERJEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? Ti N/A Y 57WECAZ7TWB 10/12/2023 10/12/2024
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,O00,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> City of Santa Ana,its City Council,its officers,officials,employees,agents,and
<br /> volunteers are Additional Insureds with respect to General and Auto Liability. Coverage is Primary&Non-Contributory and Waiver of Subrogation Applies to
<br /> General and Auto Liability per Form SS 00080405,Waiver of Subrogation applies to Workers Compensation per Form WC 04 03 06.All above provisions
<br /> are per Terms of Written Contract with the Named Insured.30 days notice of cancellation of listed policies provided in favor of Certificate Holder.
<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 /> City of Santa Ana 'ACCORDANCE WITH THE POLICY PROI` /
<br /> a„orzµrf Mana
<br /> gement.tDNision
<br /> Finance&Management Services
<br /> AUTHORIZED REPRESENTATIVE REVIEWED&APPROVED BY: t:
<br /> 20 Civic Center Plaza M-17
<br /> Santa Ana CA 92701 9.!` .: A�A6w t
<br /> Risk Management Specialist
<br /> ©1988.2015 ACOF/
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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