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A� �' CERTIFICATE OF LIABILITY INSURANCE D0/23mD019 10/23/2019 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 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 CONTACT NAME: G1IIjBr P1O11 Degginger McIntosh and Associates PHONE 1425)740-5200 FAX 3977 Harbour Pointe Blvd SW (4251140-5201 AIC NickAGGRESS: E- ginger@DMAinsurance.com INSURERS AFFORDING COVERAGE NAIC N Mukilteo WA 98275 INSURERA:HiSCOX, Inc. L19704 INSURED INSURER a: American Fire and Casualt CO. Ergometrics & Applied Personnel Research, Inc. INSURER c:Evanston Insurance Company National Testing Network, Inc. INsuRER G: 2122 164th St. SW, Suite 300 INSURERE: Lynnwood WA 980B7 nnvcmrva INSURER F: CERTIFICATE NUMBcn:19/20 CIL BA SG UmH PRO REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED"POLICYPERIODOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENESPECT TO WHICH THISCERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IST TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUERLTR POLICY NUMBER POLICY EFF POLICYEXPNimMMIDDP(YYY M DDn'YYYLIMITSA GENERALLIABILITY PL1004042.19 0/27/2019 10127/202DURRENCE S 1,000, 000X COMMERCIALGENERALLIABILITY (E mou0Ea ac hence S 50, 000CLAIMS-MADE Any one person) S 5, 000X � OCCUR X OEDOCTIHIJi: $2,500 AADV INJURY S 1,000,000 GENERALAGGREGATE S 2,000,000 GENLAGGREGATE LIMITAPPLIES PER: PRODUCTS -COMPIOPAGG 5 2,000, 000 X POLICY PRO LCC S B AUTOMOBILE LIABILITY BAA.58229925 0/27/2019 0/27/2020 COMBINED SINGLE LIMiT Eaaccident) S 11000,000 ANYAUm BODILY INJURY(Pmperem) S ALL OWNED SCHEDULEDAUTOSAUTOSBODILY INJURY (Peraccident) S Ix HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Pe aoi t S C X UMBRELLA LIAB X OCCUR BW8345119 0/27/2019 10/27/2020 EACH OCCURRENCE S 2,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE 5 2,000,000 DEO XRETENTION S 10,00 S A AVtKW)9V KIGM aI MJOXEMPLOYERS' LIABILITY L1004042.19 O/27/2019 10/27/2020 WCSTAID- X OTK YIN ANY PROPRIETOWPARTNFREXECUTIVE OFFICEWMEMBER EXCLUDED] ❑ NIA A STOP GAP E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE FA EMPLOYEE S 1 000,000 IMandalory in NH) If"s•describe under E.L. DISEASE - POLICY LIMIT 5 1,000F000 DESCRI PnON OF OPERATIONS below A PROFESSIONAL LIABILITY 1.1004042.19 D/27/2019 10/27/2020 EACH OCCURRENCE $2,000,000 DEDUCTIBLE: $5,000 TRO DATE 06-23-199B AGGREGATE $3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. if more space Is required) City of Santa Ana its officers, employees, agents and representatives are included as Additional Insured per attached Form WCLP0002CW(1014) with respect to operations of the Named Insured. Coverage is Primary/Non-Contributory per same form. Notice of Cancellation, Non -Renewal and Material Change on General Liability and Professional Liability applies per attached Endorsement WCLE6047cw(OS/13). All endorsements apply per required Written Contract. RE: NTN Testing Services City of Santa Ana Risk Management Division 20 Civic Center Plaza 4th Floor Santa Ana, CA 92702 13 2019 M. HOULE) ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE McIntosh/OGDON --, r 1 ne au tUrcu name ano logo are registered marks of ACORD