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ACCEONL-01 <br />SSALAZAR <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY)7/18/2024 <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 License # 0757776 <br />HUB International Insurance Services Inc. <br />2300 Clayton Road Suite 300 <br />Concord, CA 94520 <br />CONTACT <br />NAME: <br />PHONE FAQ No): (925) 905-5584 <br />(A/C, No, Ext): (800) 366-7050 <br />A6DRESS: jamie.rose@hubinternational.com <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Citizens Insurance Company of America <br />31534 <br />INSURED <br />Accent On Languages Inc. <br />Caroline Lee <br />2718 Telegraph Ave #104 <br />Berkeley, CA 94705 <br />INSURER B : Allmerica Financial Benefit Insurance Company <br />41840 <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD YYYY <br />POLICY EXP <br />MM/DD YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCUR <br />X <br />OBFH940265 <br />2/17/2024 <br />2/17/2025 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />300,000 <br />$ <br />MED EXP (Any oneperson) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY JE� LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />PRODUCTS - COMP/OP AGG <br />$ 4'000'000 <br />$ <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />OBFH940265 <br />2/17/2024 <br />2/17/2025 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />2,000,000 <br />$ <br />BODILY INJURY Perperson) <br />$ <br />BODILY INJURY Per accident <br />$ <br />X <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />v/N <br />ANY <br />OFFICER/MEMBER EXCLUDED? ECUTIVE <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N / A <br />W2FH940263 <br />2/17/2024 <br />2/17/2025 <br />X 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 />E.L. DISEASE - POLICY LIMIT <br />1,000,000 <br />$ <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 an additional insured with regard to general liability when required by <br />written contract per attached endorsement form 391-1006 08 16. Primary and Non -Contributory applies with regard to general liability when required by written <br />contract per attached endorsement form 391-1003 08 16. <br />SHOULD ANY OF THE ABOVE DE: <br />THE DATE THE <br />City of Santa Ana ACCORDA CETIOWITH THE POLICY <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br />Pni ICIFS RF CANCFI I Fn RFFORF <br />Risk ManaganentDivisian <br />' REVIEWED & APPROVED BY: <br />Acevato <br />® Risk Management Specialist <br />ACORD 25 (2016/03) ©1988-2015 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />