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Digitally signed by
<br />Francine R.
<br />Francine R. Villareal
<br />Villareal Date:2020.08.18
<br />75:53.42-07'00'
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMOD/YYYY)
<br />07/09/2020
<br />I
<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. If
<br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this
<br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />ADD Risk Services Central, Inc.
<br />Philadelphia PA Office
<br />CONTACT
<br />NAME:
<br />PHONE FAX (800) 363-0105
<br />(AIC(866) 283-7122 . No. Ext): A/GN.J
<br />E-MAIL
<br />ADDRESS:
<br />One Liberty Place
<br />1650 Market Street
<br />Suite 1000
<br />Philadelphia PA 19103 USA
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURED
<br />INSURER A: National Fire Ins. Co. of Hartford
<br />20478
<br />Over Drive Holdings, Inc.
<br />INSURER B: The Continental Insurance Company
<br />35289
<br />One OverDrive Way
<br />Cleveland OR 44125 USA
<br />INSURER C: Valley Forge Insurance Co
<br />20508
<br />INSURER D: Transportation Insurance Co.
<br />20494
<br />INSURERS: Indian Harbor Insurance Company
<br />36940
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 570083002389 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. Limits shown are as requested
<br />INSR
<br />LTH
<br />TYPE OF INSURANCE
<br />INSO
<br />WVD
<br />POLICY NUMBER
<br />MULus
<br />WDD/VVVVEnn
<br />MNIIDD/VVVV
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />`MI
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS MADE ❑X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Es occurrence
<br />$1,000,000
<br />MEN EXP (Any one person)
<br />$15 , 000
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />GEN'LAGGREGATE LIMITAPPLIES PER
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />X POLICY PROJECT ❑LOC
<br />PRODUCTS-COMP/OP AGO
<br />$2, 000, 000
<br />OTHER'.
<br />C
<br />AUTOMOBILE LIABILITY
<br />6080688817
<br />06/09/2020
<br />06/09/2021
<br />COMBINED SINGLE LIMIT
<br />a accident)
<br />$1,000,000
<br />BODILY INJURY( Per person)
<br />X ANVAUTO
<br />BODILY INJURY (Per accident)
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIREDAUTOS NON OWNED
<br />PROPERTY DAMAGE
<br />ONLY AUTOS ONLY
<br />Per accident
<br />B
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />CUE6080688848
<br />06/09/2020
<br />06/09/2021
<br />EACH OCCURRENCE
<br />$15,000,000
<br />EXCESS LIMB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />$15,000,000
<br />DEO I X
<br />RETENT ION $ 10, 000
<br />B
<br />WORKERS COMPENSATION AND
<br />6080688820
<br />06/09/2020
<br />06/09/2021
<br />X I PER STATUTE OTH-
<br />ER
<br />EMPLOVERS'LIABILITV V/N
<br />ADS
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />D
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />N/A
<br />6080688834
<br />06/09/2020
<br />06/09/2021
<br />OFNCER/MEMBER EXCLUDED'
<br />(Mandatory in NH)
<br />CA
<br />E.L. DISEASE EA EMPLOYEE
<br />$1,000,000
<br />It yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE POLICY LIMIT
<br />$1,000,000
<br />E
<br />Cyber Liability
<br />MTP9041302
<br />06/09/2020
<br />06/09/2021
<br />Aggregate
<br />$10,000,000
<br />Tech E&O / Prof Liab
<br />SIR per Aggregate
<br />$300,000
<br />SIR applies per policy ter
<br />is & condi
<br />ions
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
<br />City of Santa Ana, Risk Management, it's officers, employees, agents, representatives and volunteers are included as Additional
<br />Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability
<br />policy evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in
<br />accordance with the policy's provisions. Should General Liability policy be cancelled before the expiration date thereof, the
<br />policy provisions will govern how notice of cancellation may be delivered to certificate holders in accordance with the policy
<br />provisions of each policy.
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<br />CERTIFICATE HOLDER CANCELLATION = -
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th floor
<br />Santa Ana CA 92702 USA
<br />©1988-2015 ACORD CO
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br />POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />JGC�G �ILvktM
<br />Rime Mrrnagnnent Diuisian
<br />REVIEWED&APPROVED BY:
<br />® Risk Management Analyst
<br />
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