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HomeMy WebLinkAboutSERVICE FIRST CONTRACTORS DBA SERVICE 1ST (2)INSURAivtit 64 �i € �!ORK lv.Al PROCE D UNTIL IItWi,nANCE EXPIRES O: PRCS (') -1/-l>926 Silvia Cuevas )F COUNCIL MAYOR Miguel P. Pulido MAYOR PRO TEM Juan villages COUNCILMEMBERS Cecilia Iglesias David Penaloza Vacant Vicente Sarmiento Jose Solodo CITY OF SANTA ANA PARKS, RECREATION, AND COMMUNITY SERVICES AGENCY 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.ora November 14, 2019 Service First Contractor's Network dba Service lst 2510 North Grand Avenue, Suite 110 Santa Ana, California 92705 Attention: Frank Vandenberg, President A-2017-350-01 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez, MMC Re: Extension of Agreement No. A-2017-350 to Provide Fountain Maintenance and Repairs. Dear Mr. Vandenberg: Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by Service First Contractor's Network dba Service I" and the City of Santa Ana, dated December 19, 2017, the term of the Agreement is hereby extended for a one-year period, from January 1, 2020 through December 31, 2020. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement, remain unchanged and in full force and effect. Please sign below and return this extension to the City at your earliest convenience. Si cerely, Rudloff ' ` Executive Director, Parks, Recreation, and Community Services Agency CITY OF SANTA ANA Kristine City Manager APPROVED AS TO FORM A. Laura A. Rossini Senior Assistant City Attorney ATTEST 16isy Go iez6ouMC1,; 7 1erk or rmhe licit SERVICE President iST SERVICE FI CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD YriY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poticy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not Confer rights to the certificate holder in lieu of such endorsemenl(s). PRODUCER 9Pt1TACT The Wooditch Company Insurance Services, Inc. 1 Park Plaza, Suite 400 Irvine, CA 92614 INSURED A-2017-350-01 Service First Contractors Network 2510 North Grand Ave, Ste. 110 Santa Ana, CA 92705 COVERAGES CERTIFICATE NIIMRFR• REVISION NUMBER: 553-0670 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OFINSURANCE ADOL SUERJJEL pDLICY NUMBER POLICYEFF POLICYEXP LIMITS A X I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X LIG0019301 8/1/2019 _-NTf20;i0 EACH OCCURRENCE S 1.000,000 DAMAGE TO RENTED 100,00g MED EXP A dne paragal 10.000 -^- PERSONAL A ADV INJURY S 1,000.000 GEN'L AGGRE �TE LIMIT APPLIES PER. POLICY -- JEI¢ LOC GENERAL AGGREGATE S 2,000.000 PRODUCTS - COMP AGO S 2,000,000 $ OTHER AUTOMOBILE UABILRY COMBINED SINGLE LIMIT BODILY INJURY F. mro F ANYAUTO OWNED SCHEDULED AUTOS,ONLY AUTOS SSWN BODILY INJURY Per poadan1 Px etle^I AMAOE 5 RIITOS ONLY Al1TOS ONLY S UMBRELIA UAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS UA9 CLAIMS -MADE DED I I RETENTIONS S NDEPLCOMPENSATION YIN ANY PROPRIETORIPARTNERrE1fECUTNE (MenCaiRJMEMB5R EXCLUDED] yae, If deacnbe "der NIA PER OTH- Urn, T E.L EACH ACCIDENT E.L. DISEASE - EA EMPLOYE DESCRIPTION OF OPERATIONS M10. E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES (ACORD 101, Addiemlal Remarks SNeduey may M arisched it more Sp Um Imd) RE: All operations performed by the Named Insured during the current policy period. glaip City of Santa Ana, Risk Management, itb officers, employees, agents, representatives, and volunteers are included as Additional Insureds as respects General Liability per attached endorsement. This Insurance shall apply as Primary and Non-Contnbulory per attached endorsement. EVI ED & APPROVED City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92702 03 2019 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN A'rnROANCE WITH THE POLICY PROVISIONS. SAMANTHA M. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 0988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: SERVICE FI RFINLAYSON LOC #: 1 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED Service First Contractors Network 2510 North Grand Ave, Ste. 110 Santa Ana, CA 92705 POLICY NUMBER £E PAGE 1 CARRIER NAIC CODE EE PAGE 1 ISEE P 1 EFFECTIVE DAM-..qEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Celfifimte of LleblliN Insurance Cancellation: 'Except for 10 days notice of cancellation for non payment of premium. `Should this policy be cancelled before the expiration date, The Wooditch Company will mail 30 (thirty) days written notice to those Certificate Holders which require such action per contract or agreement' ACORD 101 (2008101) The ACORD name and logo are registered marks of ACORD All rinhfa m —,? POLICY NUMBER: LIG0019301 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All locations. As required by written contract. If anyone, other than the Additional Insured, provides similar insurance for the Additional Insured, then this insurance will apply as outlined in SECTION IV — COMMERICAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, subparagraph c. Method of Sharing. The inclusion of one or more Insured(s) under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the 'products -completed operations hazard". However. 1. The insurance afforded to such additional insured only applies to the extent ,permitted by law; and CG 20 37 0413 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Ace ©Insurs Office, Inc., 2012 Page 1 of 2 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 �A Mcerties, Inc., 2004 CG 20 37 0413 ❑ POLICY NUMBER: LIG0019301 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any Location As required by written contract. If anyone, other than the Additional Insured, provides similar insurance for the Additional Insured, then this insurance will apply as outlined in SECTION IV — COMMERICAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, subparagraph c. Method of Sharing. The inclusion of one or more Insured(s) under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or 'personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and CG 20 10 0413 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 4 © Insurance Se )dce, Inc., 2012 Page 1 of 2 S. With respect to the insurance afforded to these additional Insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the Insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or Page 2 of 2 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 4l2' 1 © Insurance Servi e JJ. Inc., 2012 CG 20 10 0413 Policy Number: LIG0019301 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. 4 �2211, © Insurance Services Office, Inc., 2012 Page 1 of 1 AC 120' CERTIFICATE OF LIABILITY INSURANCE t 112212019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED TE THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING AFFORDED INSURIR(S), HE POLICIES REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: B the cnmocate folder is an ADDITIONAL WSUREO, the policy(ios) must be endorsed. It SUBROGATION IS WAIVED, sub(oct to the Wron and conditions of the polity, certain policies may require an a ,dorsomonl. A statement on this ceRincater tloes not confer rights to the certir,cme holder In lieu of such cndonement(s). mr"CO, ICON ------__--__.. STATE FARM INSURANCE 1370 BREA BLVD STE 150 FULLERTON. CA 92835 A-2017-350-01 SERVICE FIRST 2510 N GRAND AVE SUITE 11 Y^ SANTA ANA. CA 92705-8754 ION[ 5267001 --- C,No.CNt.TiA•r--_—._.--. _ eef 7T4$28.03e18 IIff"" 35 JOEYOJOEYMONTGOMERY.COM -- _.. msuxexryl.rramma doYrwAGe NAIe• RACERA Stile FMm MVIUM AIA ",Od1e InNUMN eComlwry 2317e —. MIMIC" 0 IIRr<_N I•._ ' - RCNIaIUK NUMOCK: n(IS IS TO CERTIFY THAT THE POLICIES IN INSURAN,.: . MILD BELOW 14AVE BEEN ISSUED TO IHt INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY RFOUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENt WITH RESPECT TO WHICH THIS CERTIFICATE MAY HE ISSUED OR MAY PERIAM THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I$ SUBJECT TO At L THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY SLAVE HI REDUCED BY PAID CLAWS "ems TYYEa eIIIIMNC[ lOdt vl p' - IMIACYFK PIJLIGYvvry POLCYIIUYpFR UintaVA coen"Icwce"' "'ARIUTr .. fACh OCLuRRFN.^lS - _. I FRLytES lEamv_ai`.�-_ 6 I - eJ7 [AP Afy NIArcNT L -- — PCRGTtW {µ'eY R111-MT t I .In, 4e l.il Ise. K41X'+p.-Y v'[11CRK AfiC.NLI:A:E S cc, -.M eC I1i% WYJCAA. f':.C(Ye YL1P AC_A: t i A WroyrXF,k[lNOeJTY Y Y 133 3.323-FB9.75 081"12019-i.eNi � j'�e®mmr l• a S 1 WD.00c 'CI<XflY 11JAlNI IIMIr1YLV { yt .. 000tr INAatT I'Yr cNara'� S _ X Yla'Ln n. -f,. X !N;N rvNKC �eALHfr talani.E 'Ib M1 e.IlK 1s_ _ ' oeBRuu uAe ,-�_LIF I E%C[le taut. Ia A"AS-HADL� iLC✓e-(Cf.Tf t _ YnNINkR§ COMreeATgN WO rar OYERY IJABeatY YIN Zlarflik 4.1 f'r. Nr:�Tp-Y`1V YfR41 nrIn1VF ❑Ai• tl GLN AFtSI%N, IlKudu�1'910L"Xe1' n, av:uol .w. fL GSI:ASr is l.MIN ! S LY V Pep-6'ry'Ir y4RTTi 4I CRiCAST Y,py"y lRrt { orwa PTION Of oPTRAr % LOCATIONS IY[IIICas IACOIIO tar. AMNene Rewmee SOWmR he reaoe• a ewe rPlceN mq YM . SHOULD ANY Of [HE AHOVE DESCRIBED POLICIES BE CANCELLIEU OR REDUCTION IN COVERAGE BEFORE THE EXPIRATION DATE THEREOF fHE ISSUING INSURER WO I MAIL'30 DAYS Mil I LN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW ��.,�e ...... _ REVIEWFD & APPROVED--_ City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th floor Santa Ana. CA 92702 O 1OUL0 ANY OF THE ABOVE DESCRIBCD POUCICS BE CANCELLED BEFORE E EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN CCOROANCC WITH THE POLICY PROVISIONS. M. [i1WCIVr n i CJ ACORD 25 (20141f01) The ACORD name and logo are registered marks of ACORD 1001486 1 FF-WAq SECTION II ADDITIONAL INSURED ENDORSEMENT Policy No.: 133 3423•F09.75 Named Insured: SERVICE FIRST 2510 N GRAND AVE SUITE 110 SANTA ANA. CA 92705 Additional Insured (include address): The City of Santa Ana, Risk Management, its officers, employees, agents, representatives, and volunteers as additional inureds. City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4" floor Santa Ana, CA 92702 WHO IS AN INSURED, under SECTION 11 DESIGNATION OF INSURED, is amended to include as an insured the Additional insured shown above, but only to the extent that liability is imposed on that Additional Insured solely because of your work performed for that Additional Insured shown above Any insurance provided to the Additional Insured shall only apply with respect to a claim made or a suit brought for damages for which you are provided coverage The Primary Insurance coverage below applies only when there is an "X' in the box OX Primary Insurance. The insurance provided to the Additional Insured shown above shall be Primary insurance Any insurance carried by the Additional Insured shall be noncontributory with respect to coverage provided to you All other policy provisions apply 1iA:3r7 Printed in U S A rE 6671 PACE 1 Of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SCHEDULE Policy Number: 133 3423-FO9-75 Named Insured: SERVICE FIRST 2510 N GRAND AVE SUITE 110 SANTA ANA, CA 92705 VendorlD4 444670 Name and Address of Person or Organization: City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4"' floor Santa Ana, CA 92702 The following is added to Paragraph 10.b of SECTION I AND SECTION II — COMMON CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of a. Your ongoing operations; or b Your work done under contract with that person or organization and included in the products - completed operations hazard. This waiver applies only to the person or organization shown In the Schedule. All other policy provisions apply 144,611 (I. Copy^gryl. state farm Mutual Aaf Wnubdt Insurance Company. 2VJ8 Inmudes mpyrlgMril nwloual ul lnaurance Senrces Ofhre, et vntn its permlumn It ((.11104-09) e-.nted m LSA CERTIFICATE OF LIABILITY INSURANCE DATE (MM=fYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements . PRODUCER T C GIGA Solutions, Inc. PHONE isn. FpX 101 Plaza Real South L 888581-0807 rvc Nei: 964-252-4426 _ Ste 201 RE s: certs gi asolves.wm Boca Raton FL 33432,,,e„e�,e,,,e�,,,,,,,,�,.,,,2pe„� _ �— INSURED Service First 2510 North Grand Ave Santa Ana CA 92705 A-2017-350-01 COVERAGES CERTIFICATE NUMBER: 1379214336 REVISION NLIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPEOFWSURANCE IN'ID U POLICY NUMBER MWOD EFF MMIDDIVY'Y LIMITS COMMERCWLGENERALUASIUTY CLAIMS -MADE n OCCUR � EACHOCCURRENCE $ DAMAGE TO PREMI ES Ea ocanenrs 3._. MED EXP lAny one person) 3 OENLAGGREGATE . PERSONAL B AOV INJURY _ _.... 3 3 UNIT APPLIES PER POLICY1:1 JECT LOG OTHER'. GENERAL AGGREGATE PRODUCTS-COMP/OP AGG $ $ AUTOMOBB.ELUBILITY ANY AUTO omen —r SCHEDULED AUTOS ONLY (AUTOS HIRED NON-0N'ED AUTOS ONLY AUTOS ONLY COMBINED INGLELIMIT Es actltlsnf $ 9001LY INJURY (Per parson) $ --_— BODILY INJURY(Peramtltlenq $ --- — Per oddYOAMAGE Par ectltleM $ S — UMBRELLAUA8 E%CESS Wl0 OCCUR CWMSMADE EACH OCCURRENCE AGGREGATE $ S DED RETENTIONS S A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNER/ ECUTIVE ❑ OFFICER/MEMBEREXDLUDEDP IMandatoryinNHl If yyaz, tlesu;w under OESCRIPTIONOFOPERATIONS below NIA AMX-082-0021-003 ID/i/2019 .-1011/2WA..'.X TER - -' STATUTE UTE -- E L. EACH ACCIDENT —-- EL DISEASE - EA EMPLOYEE - EL DISEASE - POLICY UMIT 51.000,000 -- 51.000,000 $1.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may M aeached If more sPaoe is required) RMEWED & EmENTAPPRpOV oD CERTIFICATE HOLDER 1 I 1 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN M. AMBERT ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana MOA 20 Civic Center Plaza AUTHORUMDREPRESENTATNE Santa Ana CA 92702 A Iw `m f ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD