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_,..........441 HERBPSE-01 DHARANIREDDY <br /> 4' o, CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDmYY) <br /> 4/30/2024 <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 endorsementL�s),�. <br /> PRODUCER License#0E02096 CONTACT Ar clel�yg�t.� yl ed by Angie <br /> �I/aME: <br /> DiBuduo&DeFendis Insurance Brokers,LLC PHONE FAX <br /> 6873 N.West Ave,Ste 101 ® (A/C,No Ext): I A/C,No): <br /> Fresno,CA 93711 �` � � A E� �e <br /> � E-MAIL ,�® � m <br /> (y�� '� C 1 NAIC# <br /> : INSURERF:C�ir �,. <br /> INSURED INSUPar.6: 1 <br /> Herbert P.Sears Co.,Inc., DBA:HP Sears IRE I'.ERC: <br /> 2000 18th Street INSURER D: <br /> Bakersfield,CA 93301 <br /> •INSURER E: <br /> I <br /> 1 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 rPOLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE i„DCL SUER POLICY NUMBER POLICY EFF POLICY EXP <br /> LTR INSD 1M1D (MM/DD/YYYY) (MM/DD/YYYY) LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR X X 51SBATU2232 5/2/2024 5/2/2025 DAMAGE TO RENTED 1,000,000 <br /> PREMISES lEa occurrence) $ <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 PRO- <br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) $ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident)_ $ <br /> A�R OS ONLY AUOTN S ONLY PROPERTY DAMAGE <br /> (Per accident) $ <br /> $ <br /> UMBRELLA UAB _ OCCUR iI I EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE' I AGGREGATE $ <br /> DED RETENTION$ I ! $ <br /> WORKERS COMPENSATION i I PERTUTE I I ERH <br /> AND EMPLOYERS'LIABILITY <br /> Y/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? NfA' <br /> (Mandatory inNH} E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> i <br /> A Crime(Includes Burg 51S3ATU2232 5/2/2024 5/2/2025 Limit 50,000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Santa Ana is named as Additional Insured under the General Liability per the Additional Insured form SS0008 0405 as respects Operations of the <br /> Named Insured.Waiver of Subrogation applies to the General Liability per form SS0008 0405. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City of Santa Ana THE EXPIRATION DATE THEREOF / <br /> ACCORDANCE WITH THE POLICY PRC l Division <br /> Attn:Alex Gutierrez,Treasury and Customer Service Manager ,��="'"� /'b17°8ement <br /> 20 Civic Center Plaza R 3' EVIEWED&APPROVED BY: <br /> Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE .i. Id`•; 114.14. <br /> A Ratak <br /> A-441 ° ;® Risk Management Specialist <br /> I <br /> ACORD 25(2016/03) ©1988-2015 ACORDRPORATION. All rights reserved."" <br /> Me ACORD rz,-^e and logo are registered marks of ACORD <br />