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7OT7/01/2024 <br /> E(MM/DDYYYY) <br /> ACC" CERTIFICATE OF LIABILITY INSURANCE <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 endorsements . <br /> PRODUCER CONTACT <br /> NAME: _ <br /> Next First Insurance Agent nc. PHONE 55 <br /> PO BOX 60787 A/C No Ext: <br /> Palo Alto,CA 94306 Anqie <br /> E-MAIL su ort xtin u ante. <br /> A-MAIL PP <br /> INSURER( AFFORD G COVERAGE NAIC# <br /> INSUREF di n n p ,Ie 0 <br /> 12831 <br /> INSURED <br /> INSURE :B <br /> Ivan Marquez <br /> Chanel Torrez City of SAcevedo <br /> isk management Division INSUr _RC <br /> 20 Civic Center Plz INS RER D: LJC1 • • • <br /> Santa Ana,CA 92701 <br /> P SURER E: <br /> INSURER F: • • <br /> COVERAGES CERTIFICATE NUMBER:711769Ps7 • • E ISIO B <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELU` 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 ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER <br /> POLICY EFF POLICY EXP <br /> LTR MM/DD/YYYY MM DD YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 <br /> DAMAGE TO_7TED CLAIMS-MADE � OCCUR PREM SES Ea occurrence)rrence $100,000.00 <br /> MED EXP(Any one person) $15,000.00 <br /> A X NXT9W7H7TH-01-GL 10/07/2023 10/07/2024 PERSONAL&ADV INJURY $1,000,000.00 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000.00 <br /> POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OPAGG $2,000,000.00 <br /> X JECT <br /> OTHER: I $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTYDAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? ❑ N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> The Certificate Holder is City of Santa Ana.A Waiver of Subrogation applies in favor of this Certificate Holder on the following policies:General Liability.This Certificate Holder, <br /> City of Santa Ana,its City Council,its officers,officials,employees,agents,and volunteers are Additional Insured on the General Liability policy per the Additional Insured <br /> Automatic Status Endorsement.This Certificate Holder will receive at least 30 days prior written notice of cancellation,for any reason including for nonpayment,of any of the <br /> following policies:General Liability.All Certificate Holder privileges apply only if required by written agreement between the Certificate Holder and the insured,and are subject <br /> to policy terms and conditions. <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Santa Ana LIVE CERTIFICATE <br /> 20 Civic Center Piz SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Santa Ana,CA 92701 THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PRC <br /> Risk Management Division <br /> AUTHORIZED REPRESENTATIVE 3' REVIEWED&APPROVED BY. <br /> °�; A�e Atet�ulo <br /> ❑ ® Risk Management <br /> Click or scan to view Specialist� <br /> ©1988-2015 ACORD <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />