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AC"R"CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />O8/05/2024
<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 />Tami Van Ert
<br />The Liberty Company Insurance Brokers
<br />xt : (888) 918-3960 FAX
<br />No):
<br />Lic #OD79653
<br />tvanen@libertycompany.com
<br />:
<br />5955 De Soto Ave, Ste 250
<br />Ande Acciteve.:
<br />_
<br />�e
<br />),6k nj ,� G n i e6.1
<br />;INSURER
<br />e c #
<br />kle Nati s r y r
<br />5-in
<br />t38911
<br />Woodland Hills
<br />INSURED
<br />B: IAA an arbor Ins O '
<br />36940
<br />Veritone, Inc.
<br />C :
<br />5291 California Ave, Ste 350
<br />D :
<br />INSURER E :
<br />Irvine CA 92617
<br />1INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 24-25 GLAUW & 24-25 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO\7V4TAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />(MM/DD/YYYY)
<br />POLICY EXP
<br />(MMIDDIYYYY)
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE F OCCUR
<br />PREMISES DAMAGE ORENTED (Ea occurrence)
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 15,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />Y
<br />TCP7012737-16
<br />06/11/2024
<br />06/11/2025
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />X POLICY ❑ PRO ❑
<br />JECT LOC
<br />PRODUCTS - COMP/OPAGG
<br />2,000,000
<br />$
<br />$
<br />OTHER,
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTC
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />Y
<br />Y
<br />TCP7012737-16
<br />06/11/2024
<br />06/11/2025
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />HIRED �/ NON -OWNED
<br />AUTOS ONLY /� AUTOS ONLY
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />Y
<br />Y
<br />TCP7012737-16
<br />06/11/2024
<br />06/11/2025
<br />DED I I RETENTION $
<br />$
<br />p`
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY v / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />(Mandatory in NH)
<br />N/A
<br />Y
<br />TWC7012814-16
<br />06/11/2024
<br />06/11/2025
<br />PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />1, 000, 000
<br />$
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 1,000,000
<br />If Ves, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE- POLICY LIMIT
<br />1,000,000
<br />$
<br />B
<br />Cyber Liability/Technology Products and
<br />Services - Claims Made
<br />Y
<br />Y
<br />MTP904363103
<br />08/01/2024
<br />06/11/2025
<br />Annual Aggregate
<br />Retention - Per Claim
<br />$5,000,000
<br />$250,000
<br />Full Prior Acts
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Whereby required by written contract or agreement, City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are included
<br />as an Additional Insured under the Commercial General Liability on a Primary/Non-Contributory basis. Waiver of Subrogation in favor of the Additional
<br />Insured applies to the General Liability.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICF WILL FIF DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PRO)
<br />Riele Maragerrtent t7ivision
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE if REVIEWED & APPROVED BY.
<br />ai
<br />Santa Ana CA 92702 n w _r Risk Management Specialist
<br />@ 1988-2015 ACOF
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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