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�1 <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDONM) <br />02/29/2024 <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 <br />Automatic Data Processing Insurance Agency, Inc. <br />1 Adp Boulevard <br />NAME; C Automatic Data Processing Insurance Agency, Inc. <br />PHONE 1-800-524-7024 FAX <br />A/C No Eat: A/C No <br />EIAAIL <br />ADDRESS: <br />Roseland NJ 07068 <br />INSURER(S)AFFORDINGCOVERAGE <br />NAICp <br />INSURER A; Travelers Property Casualty Company of America <br />25674 <br />INSURED Java Connections, LLC <br />INSURER B: <br />INSURER C : <br />17304 Preston Rd <br />Ste 800 <br />Dallas TX 752525645 <br />INSURER 0 <br />INSURER E : <br />INSURER F: <br />CY WIVIY IY YIYI6CR: <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 />TN —SR R ADD TYPE OF INSURANCE INS BUBD POLICY NUMBER MM/D/YYYY MMIDDIYYXYY LIMITS <br />LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE <br />$ <br />PREMISES Esaccumance <br />$ <br />qCOMMERCIALGENERAL <br />MED EXP (Any we person) <br />$ <br />GEN'L <br />PERSONAL&ADV INJURY <br />$ <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ PR <br />POLICY LOG <br />OTHER: <br />GENERAL AGGREGATE <br />- <br />$ <br />PRODUCTS-COMP/OP AGG <br />$ <br />- <br />$--AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON-OWNEDLY <br />AUTOS ONLY AUTOSSONLY <br />COMBINEDLE LIMIT <br />Ea accident) <br />$ <br />BODILY INJURY(Perpersm) <br />$ <br />BODILY INJURY (Per accident) <br />-DAMAGE <br />$ <br />FIROPERTY Perraccident) <br />$ <br />A <br />UMBRELLA LIAR <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />N/A <br />N <br />UB-7P272097-24-42 <br />03/15/2024 <br />03/15/2025 <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DEO RETENTION$ <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LIABILITY Y/N <br />MY OFFICEMMEM ER EXCLUDED?XECUTIVE FY—] <br />(f NH) <br />Ryes, d <br />yes.describe (Mandatory and <br />DESCRIPTION OF OPERATIONS below <br />PER O - <br />STATUTE ER <br />$ <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS /LOCATION$ /VEHICLES (ACORO 101, Additional Remarks Schetlule, may be attached if more space is required) <br />City of Santa Ana Risk Management Division <br />20 Civic Center Plaza <br />4th Floor <br />Santa Ana CA 92702 <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 PR( <br />AU IMUKUhU REPRESENTATIVE <br />©1988-2015 ACC <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />�\ <br />Risk MougonedDitti im <br />REVIEWED&APPROV®BY: <br />s tillll <br />A+�crAde(A <br />® <br />Risk Management SpeciAct <br />