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Digitally signed by Francine R.
<br />Francine R. Villareal vilbreal
<br />Date :mn.o2M 15:1940 00'00'
<br />ACORL7® CERTIFICATE OF LIABILITY INSURANCE
<br />2/l/2022
<br />O1/26 , °°" YY'
<br />1/26/2021
<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.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement an
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER Locklon Insurance Brokers, LLC
<br />777 S. Figueroa Street, 52nd Fl.
<br />CA License NOF15767
<br />Los Angeles CA 90017
<br />CONTACT
<br />NAME:
<br />PHCNE FAX
<br />'V N NC No:
<br />ADDRESS:
<br />(213)689-0065
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICO
<br />INSURER A: Crum & Forster Specialty Insurance Co
<br />44520
<br />INSURED Rincon Consultants Inc
<br />1462718 180 N. Ashwood Ave.
<br />INSURERS: Hartford Fire Insurance Company
<br />19682
<br />INSURER C:StarstoneNational Insurance Company
<br />25496
<br />INSURER 0,
<br />Ventura CA 93003
<br />INSURER E :
<br />INSURER F:
<br />COVERAGES RINCO01 CERTIFICATE NUMBER: 16059509 REVISION NUMBER: 7{
<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.
<br />INSR
<br />rypE OF INSURANCE
<br />ADDL
<br />I D
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMmO
<br />POLICY UP
<br />MMmO
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />EPK-133853
<br />2/1/2021
<br />2/1/2023
<br />EACH OCCURRENCE
<br />$ 3 000 000
<br />CLAIMS -MADE 1XI OCCUR
<br />PREMISES Ea occurrence
<br />$ 100,000
<br />X
<br />MED UP (Any one Person)
<br />$ 10,000
<br />SIR: $50,000
<br />X
<br />P&I
<br />PERSONAL B ADV INJURY
<br />$ 3,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERA -AGGREGATE
<br />$ 4000000
<br />POLICY JECT LOC
<br />PRODUCTS-COMPIOPAGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />72UENOL5481
<br />2/1/2021
<br />2/1/2022
<br />COMBINEDBISINGLE LIMITMe
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$ ice"'
<br />MY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$ ice• •'
<br />X
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per acoiden
<br />$ ice..
<br />A
<br />UMBRELLA Las
<br />X
<br />OCCUR
<br />N
<br />N
<br />EFX-116867
<br />2/1/2021
<br />2/1/2022
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />X
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LUAB
<br />CLAIMS -MADE
<br />DED I X I RETENTION $ 10,000
<br />$ ice'
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y/N
<br />ANY PROPRIETORIPARTNERIEXECLUIVE
<br />OFFK:ERIMEMBER EXCLUDED?
<br />(Men- ryInNH)
<br />N/A
<br />Y
<br />T10210329
<br />2/1/2021
<br />2/1/2022
<br />PER OTH-
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1000000
<br />E.L.DISEASE -EA EMPLOYE
<br />$ 1000000
<br />if ibe under
<br />DESCRIPTION OF OPERATIONS below
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Contractors Pollution Liab
<br />N
<br />N
<br />EPK-133111
<br />2/l/2021
<br />2/1/2023
<br />Limit: $3,000,000/$4,000,000
<br />E&O Liab.-Claims Made
<br />Limit: $3,000,000/$4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be albehed If more space Is required)
<br />MS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FORMS DOLDER,APPLICABLE TO THE CARRMRS LISTED AND THE POLICYTERM(S) REFERENCED.
<br />Cyber Liability: Ca w HDI Specialtyhraurance Company, Policy No. Renewal Policy P SCfRD2590380000, Policy Term: 2/l2021-2/l2022, Limit: $5,000,000 SIR: $10,000
<br />The City of Santa Ana and Community Developmentalgevcy and their officinal, employees, agents and volunteers are on Additional humsed to the estentprovided by thepolicy language
<br />or ondorsement issued or approved by the insurance carrim. Waiver of Subrogation applies per attached evdmacrobal or policy langul hauranceprovided to Additional humbod(s)
<br />is primary and mnconhibubry as the attached evdoracmont orpolicy language. recess policy follows General Liability Auto Liability and Employers Liability form. Notice of
<br />Cancellation applies per the app&able policy language or evdoracri
<br />16059509
<br />City of Santa Ana
<br />Risk Management Divison
<br />20 Civic Center Plaza, 4th Floor
<br />Santa Ana CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORMED
<br />ACORD 25 (2016/09) The ACORD name and logo are registered marks of ACORD
<br />Kski ayogarunntDivision
<br />ram.
<br />rREmEWED &{APPRcyvED By.,
<br />r �_4.IIri _II.IP:L' b6HlM�e vdt, t¢
<br />'� Risk Management Analyst
<br />
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