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CC] ID: 4MGKV
<br />A� oR®® CERTIFICATE OF LIABILITY INSURANCE
<br />DATEIMM/OD YYY)
<br />11/1912024
<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 />WRIS, Inc. dba Western Republic Insurance Services
<br />19900 Beach Blvd.
<br />NAMEACT Dustin Keeney
<br />PHO(A/C N �). 8884671718
<br />ADDRESS: dustin@wrinsurance.com
<br />INSUI AFFORDING COVERAGE
<br />NAICB
<br />Suite F1
<br />INSURERA: Colony Insurance Company
<br />39993
<br />Huntington Beach CA 92648
<br />INSURED
<br />INSURER B: California Automobile Insurance Company
<br />38342
<br />INSURER C: Scottsdale Insurance Company
<br />41297
<br />Golden Meters Service, Inc.
<br />INSURER D: Security National Insurance Company
<br />33120
<br />14812 Hunter Ln
<br />INSURER E :
<br />INSURER F:
<br />Midway City CA 92655
<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 LTR TYPE OF INSURANCE ANs.DDL SUBR POLICYNUMBER POLICY
<br />MMIDDIYVYY LIMITS
<br />X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br />DAMAGE TO RENTED CLAIMS -MADE � OCCUR PREMISES Ea occurren e $ 100,000
<br />MED EXP(Any one person) $ 5,000
<br />A Y Y 600 GL 0217377-00 09/09/2024 09/09/2025 PERSONAL &ADV INJURY $ 1,000,00D
<br />GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br />X POLICY ❑ PRO- ❑ LOG PRODUCTS - COMPIOP AGO $ 2,000,000
<br />JECT
<br />OTHER', $
<br />AUTOMODILELIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br />_{Ea accident
<br />IANY AUTO BODILY INJURY /Per person) $
<br />OWNEDX SCHEDULED Y BA040000088824 04/15/2024 04/15/2025 BODILY INJURY (Per accldenD $
<br />AUTOS ONLY AUTOS ---
<br />HIRED NON -OWNED Pe�ec cdon DAMAGE $
<br />AUTOS ONLY X AUTOS ONLY
<br />X I UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 4,000,000
<br />C Exc ESS LIAB _ CLAIMS -MADE CXS4032619 09/09/2024 09/09/2025 AGGREGATE $ 4,000,000
<br />DED RETENTION $
<br />WORKERS COMPENSATION X PER
<br />ERII-
<br />AND EMPLOYERS' LIABILITY —'—'-'—
<br />D OFFICE PRICTOWPAR N ER/EXECUTIVE Y❑ NIA Y SWC1481305 03/07/2024 03/07/2025 E.L. EACFI ACCIDENT $ 1,OOD,000
<br />(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />If Yes, describe under 1,000,D00
<br />DESCRIPTION OF OPERATIONS below E.L. DISEASE � POLICY LIMIT $
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Those usual to the insured's operations. City of Santa Ana, officers, agents, employees, and volunteers are named as additional insured per the attached CG 20
<br />10 12 19, CG 20 37 12 19, and MCA20480711. Waiver of subrogation applies per the attached CG 24 04 12 19 and WC 04 03 06. Insurance is primary and non-
<br />contributory per the attached CG 20 01 12 19. Provide On -Call Meter Testing Services
<br />APPROVE®
<br />r•enlrFl I ;•y Cynthia Moraaf 1:58-pm, Nov--27; 2024'.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana CA 92701
<br />..�..---a""..-rFm- - �.-: y-_-._. ___•''F'I. ,.�. .z„.,,,,V_,�,-_
<br />to 1988-ZUT5 ACURU CORPORATION. ION. An rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />COI ID: 4MGKV
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