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'S� eJ CERTIFICATE OF LIABILITY INSURANCE TE(MWDDNYYY) 0 7/22/2019 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(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 CONTACT PAYCHED(INSURANCE AGENCY INC 150 SAWGRASS DR ROCHESTFJ2, N1Y 14620 (877)362-6785 PHDNE FAX AIC No Eat); 87 362-6785 A/C No): 877 677-0447 E-MA L o Nel.... INSURER(S)AFFOROINGOOVEtAOE NAIC# INSURERA : TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA INSURER B: INSURED AMERICA ON TRACK 600 W SANTA ANA BLVD INSURERC: STE 710 SANTA ANA, CA 92701 INSURERD: INSURERS: INSURERF: -- — — ov< RCVIJIVry rvUMCCK: 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 TR TYPE OF INSURANCE ADO INSD SUER WVD POLICY NUMBER MMPO/ODDYEFF YY POLICY EXP MM DD YY LIMITS COMMERCIAL GENERAL LIABILRY EACH OCCURRENCE $ CLAIMSMADE OCCUR OAMA E TO D MI $ MED EXP An one arson $ -GENT PERSONAL S ADV INJURY $ AGGREGATE LIMB APPLIES PER: POLICY ❑ PRO- �LOC GENERAL AG GATE PRODUCTS -COMPIOPA $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea acculent) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraockenl) $ $ UMBRELLA LIA6 EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ DED RETENTION $ AGGREGATE $ WORKERSCOMPENSATIONNSBILIT OYERS'LIABILfrY YIN RIETORIPARTNEWEXECUTIVE EMBER EXCLUDED'! � in NH) tfas, ibe under ONOFOPERATIONSbelm NIA UB-3L272199-19 01/01/2019 01/01/2020 SSTTR ER X E.L. EACH ACCIDENT $ 1 OOO 000 E.L. DISEASE -EA EMPLOYEE $1 000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) REVIEWED & APPROVED By Risk MANAgEMENT DIVISION CFRTIFICATP 4N11 III L I CITY OF SANTA ANA RISK K~GEMENIT DMSION 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN M. LAMBERT ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,/ - Hg/WLl AV 1988-ZU15 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD