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(SII 2_01t• li-t5 HSGINCO-OT LYLI ,4COR0° CERTIFICATE OF LIABILITY INSURANCE 08/07/2018 D08/071201Y 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 endorsement(s). PRODUCER License # 0757776 N°A p" Diana Frausto PHONNo, Ext): (805) 879-9524 AIX, No) (805) 617.1762 Santa Barbara, CA - HUB International Insurance Services Inc. PO Box 3310 Santa Barbara, CA 93130-3310 E-MAIL ADDRESS: Diana.Frausto@HUBinternational.com 09/0112019 INSURERS AFFORDING COVERAGE NAIC# DAMAGE TO RENTED 500,000 PREMISES Ea occurrence $ INSURER A: West American Insurance Co 44393 INSURED INSURER B: Ohio Security Insurance Company 24082 HSG Inc HSG, Inc DBA: Control Concepts 6925 Aragon Cir Ste 2 wsuRERC:American Fire and Casualty Company 24066 INSURER D:Oak River Insurance Company 34630 INSURER E: Buena Park, CA 90620 INSURER F: COVFRAGFS CERTIFICATE NUMRFR- REVISION NUMBER - 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. I.ToNSRTYPE OF INSURANCE ADDL IN D SUBR W VD pOLICV NUMBER POLICY EFF MM DD1YYri POLICY EXP MM DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCURBKW1958251804 X 09101/2018 09/0112019 EACH OCCURRENCE $ 1'000'000 DAMAGE TO RENTED 500,000 PREMISES Ea occurrence $ MED EXP Amy oneperson) $ 15'000 PERSONAL B ADV INJURY $ 1'000'000 GENE AGGREGATE LIMIT APPLIES. PER: PRO- POLICY JECT X LOC OTHER: GENERAL AGGREGATE $ 2'000'000 2,000,000 PRODUCTS - COMP/OP ASS $ $ B AUTOMOBILE X X LIABILITY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY X AUUTNOS ONLYY BAS58251804 09/01/2018. 09101/2019 COMBINED SINGLE LIMIT 1,000,000 Ea .cc rub BODILY INJURY Perperson) $ BODILY INJURY Per accident PPor accGon[ AMAGE C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ESA58251804 0910112018 09101/2019 EACH OCCURRENCE $ 2'000'000 AGGREGATE $ 2'000'000 DEDTX] RETENTION$ D D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE WFICERIMEMBER EXCLUDED? Y (Mandatory In NH) # yes, describe under DESCRIPTION OF OPERATIONS below NIA HSWC909577 0210112018 02101/2019 X STATUTE OTT ER 1,000,000 EL EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ 1'000'000 EL.DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) The City of Santa Ana, it's officers, employees, agents, and representative are named as additional insured's under the general liability policy as coverage applies when required by written contract per attached form #CG 88 10 04 13. " , gI(i I"1 118, Nc, 1 o -f (0 City of Santa Ana Attn: Kathia Reyes 220 S. Daisy M-85 Santa Ana, CA 92703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RA 4