|
DATE(MMIDDIYYYY)
<br /> ACORD® CERTIFICATE OF LIABILITY INSURANCE
<br /> `------ 12/1/2024 5/22/2024
<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 LOCKTON COMPANIES CONTACT
<br /> NAME:
<br /> 500 West Monroe,Stti 400 • PHONE DigitaIIyIigned
<br /> (A/C.No,Ext):
<br /> CHICAGO IL 60661 E-MAIL
<br /> (312)669-6900 ADDRESS:
<br /> midwestcertificates ,lock 1. In IN URER(S)AFF DING COVER.A E NAIC#
<br /> INSURER A:TI-. Cl ak _ e�1 _ tp rAc e`, o
<br /> INSURED SDI Presence LLC INSURER B:T le D eiyC II u P1ct iftp Tiy V
<br /> 1427688 200 E. Randolph St INSURER C:' ravCelt. ;Property Casualty Corn any of America 25674
<br /> Ste 3550 I URER C --- SEc'a EN
<br /> Chicago IL 60601 UR, he T-. ra �i1 CO t nn di • 2
<br /> COVERAGES AEcCeU\i
<br /> e19 o U 0 1 � •{/1�oL�dUL I.I 1('1`�,,'e'BE :
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW N.VE JEEN ISSUED TO1fHIINi;UB�61�11r1 A�JE Ft TOPOR1/410D
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION ',F 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 LTR IN SD SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> TYPE OF INSURANCE (MM/DDIYYYY) (MM/DD/YYYY)
<br /> B X COMMERCIAL GENERAL LIABILITY Y N H-630-0S724669-PIIX-23 6/1/2023 12/1/2024 EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 1,000,000
<br /> MED EXP(Any one person) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY JE� X LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY N N 810-0S724577-23-13-G 6/1/2023 112/1/2024 COMBINED NGLE LIMIT $
<br /> (Ea accidenUSI 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS XXXXXXX
<br /> HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX
<br /> AUTOS ONLY AUTOS ONLY (Per accident)
<br /> $ XXX� �XX
<br /> C x UMBRELLA LIAB X OCCUR N N CUP-0S724762-23-13 6/1/2023 12/1/2024 EACH OCCURRENCE S 25,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE S 25,000,000
<br /> DED X RETENTION$ 10,000 $ XXXXXXX
<br /> WORKERS COMPENSATION PER OTH-
<br /> E AND EMPLOYERS'LIABILITY Y(N N UB-0S724412-24-13-G 6/1/2024 12/1P024 X STATUTE 1 ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000 000
<br /> OFFICER/MEMBER EXCLUDED? N
<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 $ 1,000,000
<br /> D Professional N N SEE ATTACHED 12/1/2023 12/1/2024 50M each claim&aggregate limit,
<br /> Liability/Technology E&O/ $250,000 retention
<br /> Cyber
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> The City of Santa Ana,its officers,officials,employees,and volunteers are included as additional insured on a Primary and Non-contributory basis if required by written
<br /> contract with respect to General Liability per the terms and conditions of the policy where pennitted by state law.
<br /> CERTIFICATE HOLDER CANCELLATION See Attachments
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 19199585 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PRC\
<br /> ��,H Risk Mo ogetnent Division
<br /> Risk Management Division AUTHORIZED REPRESENTATIVE_.---- r'�Q+ REVIEWED&APPROVED BY:
<br /> 20 Civic Center Plaza, `i'n1I111 F1 flcevtcla
<br /> Santa Ana CA 92702 f
<br /> J/ i �':
<br /> I /1 '•,, -�� Risk Management Specialist
<br /> ©1988-20 5 ACORD / \
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
|