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ACORO® CERTIFICATE OF LIABILITY INSURANCE
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<br />ATE
<br />D06/03/2020 Y)
<br />06/03/2020
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsemen s .
<br />PRODUCER LICENSE NO. 0637431
<br />NCONTACT
<br />AME: PATRICK MCRAE
<br />PATRICK MCRAE INSURANCE SERVICES
<br />1265 N. MANASSERO ST. SUITE 303
<br />ANAHEIM HILLS, CA 92807
<br />PHONE 714) 779-6999 FIFAORC. N„ (714) 779-6903
<br />Eo AJL s: mcrae s lobal.net
<br />INSu S AFFORDING COVERAGE
<br />NAIO0
<br />INSURERA: CRUM & FORSTER SPECIALTY INSURANCE
<br />44520
<br />INSURED
<br />INSURERB: INSURANCE COMPANY OF THE WEST
<br />27847
<br />INSURER C: INTEGON NATIONAL INSURANCE COMPANY
<br />29742
<br />CROSSTOWN ELECTRICAL & DATA, INC.
<br />5454 DIAZ STREET
<br />IRWINDALE CA 91706
<br />INSURER D: ATLANTIC SPECIALTY INSURANCE COMPAN
<br />27154
<br />INSURER E: GREAT AMERICAN INSURANCE CO.
<br />16691
<br />1 INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: RFVISInN NUMRFR-
<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 INSURANCEAM
<br />W9R
<br />POLICY NUMBER
<br />Y EFF
<br />MW
<br />POLICY a"
<br />II
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERALIIANLITY
<br />CLAIMSWADE Z OCCUR ✓
<br />XCU
<br />X
<br />X
<br />GLOO65967
<br />DEDUCTIBLE $5,000 PER
<br />OCCURENCE
<br />06/03/202
<br />0 /0312021
<br />EACH OCCURRENCE
<br />f 1,000,000
<br />PREMISES Ea o wrtance
<br />S 100,000
<br />X
<br />MED EXP (Any one pB )
<br />S 5.000
<br />X
<br />OCP
<br />PERSONAL & ADV INJURY
<br />IT 1,000,000
<br />GENL
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY AI ECT LOC
<br />GENERAL AGGREGATE
<br />S 2,000,000
<br />PRODUCTS-COMP/OP AGG
<br />S 2,000,000
<br />EBL
<br />S 1,000,000
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY ✓
<br />ANY AUTO
<br />X
<br />X
<br />2005675448
<br />11/05/201911/05/2020
<br />COMBINED
<br />IN LELIM (Es acadent)
<br />f 1,000,000
<br />X
<br />BODILY INJURY(Per Person)
<br />S -
<br />I
<br />ALL AUTOS AUTOS
<br />AUTOSSCHED
<br />HIRED AUTOS NON -OWNED
<br />AUTOS
<br />Ix
<br />BODILY INJURY (Per scrJtlerk)
<br />S -
<br />X
<br />PROPERTY DAMAGE
<br />Par - m
<br />S
<br />f
<br />E
<br />UMBRELLA LAB
<br />ExcEssLAs
<br />X
<br />OCCUR
<br />CLANS -MADE
<br />TUE 2572052 02
<br />UNDERLYING LIMITS:
<br />GL; AL; EL POLICIES
<br />06/03 2020
<br />061 33/2021
<br />EACH OCCURRENCE
<br />f 10,000,000
<br />X
<br />AGGREGATE
<br />f 10,000,000
<br />X
<br />DED
<br />RETENTIONS 0
<br />f
<br />B
<br />YNUEPIEELWTINN
<br />AMOYk3IA�N
<br />ANY PROPRIETORIPARTNER/EXECUTIVE OEPICER/LIEMBER EXCLUDED? �
<br />(Myaawakimry In NH)
<br />DESCRIPT10 0 OrPERAT10NS eabx
<br />NIA
<br />x
<br />WVE 5030354-05
<br />06/03/202006/0312021
<br />�/
<br />X sin ER
<br />E.L. EACH ACCIDENT
<br />It1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />S 1,000,000
<br />E.L. DISEASE -POLICY LIMB
<br />It 1,000,000
<br />D
<br />PROPERTY &
<br />CONTRACTORS
<br />EQUIPMENT
<br />710039414
<br />$1,000 DEDUCTIBLE
<br />COV. INCL. THEFT
<br />05/10/2020
<br />05110/2021
<br />a ^91
<br />pp
<br />f1i,41&,&598 Pm,reny ax Premises
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<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ACORD 101, AUtlkkmal Remarks Sch"W may 1» atbeMtl If moro sW u M requlrom
<br />THE CITY OF SANTA ANA, ALONG WITH THEIR O�FICERS, OFFICIALS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH
<br />RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED�Y
<br />WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. �_
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED.
<br />RE: Agreement #A-2017-172
<br />CTWN: 3196
<br />City of Santa Ana Y '
<br />20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />JU 19 &E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />ANC11E
<br />REPRESENTATIVE ,2
<br />© 1988-2014 ACORD CORPORATION All rmhto, rnenrvcH
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<br />AGVKLI Z5 (ZU141U1) The ACORD name and logo are registered marks of ACORD
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