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CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MINIDDIYYYY) <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(les) must be endorsed. If SUBROGATIONIS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s), <br />PRODUCER_ <br />BIZINSURE LLC/PHS <br />CONTACT ---��� --- <br />NAME: <br />LIMITS <br />57102005 <br />THE HARTFORD BUSINESS SERVICE CENTER <br />3600 WISEMAN BLVD <br />SAN ANTONIO, TX 78265 <br />(AIC, o, San; (866) 467-8730 <br />FAX <br />No): (888) 443-6112 <br />EMAIL <br />CLAIMS-MAOE OCCURAIA <br />X General Liability <br />ADDRESS' <br />SURERIS) AFFORDING COVE GE NAICM <br />INSURED <br />NSURII The Twin City Fire Insurance Company <br />29459 <br />Hall Aquatic Life Support Designs DBA Hall Aquatic Design LLC <br />347 GRANT ST SE <br />ATLANTA GA 30312-2226 #J -�(�� 3��Q,� <br />INSURER B: The Hartford Accident and Indemnity <br />Insurance Company <br />22357 <br />INSURER : <br />INSURER D : <br />11/09/2018 <br />11/09/2019 <br />INSURER E: <br />GENT. AGGREGATE LIMIT APPLIES PER: <br />POLICY [] PRO. LCC <br />JECT X <br />GENERAL AGGREGATE $4,00000 <br />INSURER F : <br />I01=1tlydy 10I 2191417x77 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED T THE IN URD NAME ABOVE FOR THE POLICY PERIOD <br />INDICATED,NOTWTHSTANDING 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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LS <br />TR <br />-- <br />TYPE OF INSURANCE - -POOL <br />SANTA ANA CA 92701-4058 <br />Ue <br />-pOLIPY NUMBER - <br />""'P061CY EFf----__—M01 <br />IMMIDDrMYl <br />'E%Y- <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $2000,000 <br />CLAIMS-MAOE OCCURAIA <br />X General Liability <br />.NTED $1,000,000 <br />PREMISES aoclrtrenc <br />X <br />NED EXP (Any one person) $10,000 <br />A <br />57 SBM BL2522 <br />11/09/2018 <br />11/09/2019 <br />PERSONAL ED� vY 0 <br />GENT. AGGREGATE LIMIT APPLIES PER: <br />POLICY [] PRO. LCC <br />JECT X <br />GENERAL AGGREGATE $4,00000 <br />PRODUCTS � COMPIOP AGO $4,000,00 <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT $2,000,QO <br />(Ea accident) <br />ANY AUTO <br />INJURY (Per parson) <br />A <br />ALL AUTOS ED SCHEDULED <br />X HIREDAUTOS X ROTO WNED <br />57 SBM BL2522 <br />11/09/2018 <br />11/09120M <br />�d�\� <br />DILY INJURY(Peraca <br />ERT <br />ccide <br />UMBRELLA LIAR <br />OCCUR <br />q <br />"— <br />EXCESS LIAR <br />CLAIMS•MAOE <br />C��WORKERS <br />1E.L. <br />DED <br />RETENTIONS <br />COMPS SATION <br />EMPLOYERS'LUBILITY <br />y <br />KSTATUTEANY <br />PER X pTH.AND <br />PROPRIETOMPARTNERIEXECUTIVE YIN <br />OFFICERIMEMBEREXCLUDED? <br />(Mandatary In NH) <br />NIA <br />57 WEC AC3MZN <br />11/0912018 <br />11/09/2019-- <br />ACH ACCIDENT $1,000,0B <br />2 <br />E,L. CISEASEEA EMPLOYEE $1,000,000 <br />yes. describe urger <br />If <br />bESCRIPTITIONP <br />E.L. DISEASE• POLICY UNIT $1,000,00 <br />A <br />EMPLOYMENT PRACTICES <br />LIABILITY <br />57 SBM BL2522 <br />11/0912016 <br />11109/2019 <br />Each Claim Limit $10,00 <br />Aggregate Limit $10,00 <br />DESCRIPTION OFOPERATIONS/LOCATIONS IVEHICLES (ACORD 131, Additional Remarks Schedule, maybe attached if mom space Is required) <br />Those usual to the Insured's Operations. The city of Santa Ana, Its officers, employees, agents and representatives are named as additional Insured per the <br />Business Liability Coverage form, SS0008, attached to this policy. 30 Day Notice of Cancellation applies. <br />CERTIFICATE HOLDER CANCELLATION <br />THE CITY OF SANTA ANA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />20 CIVIC CENTER PLZ <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />SANTA ANA CA 92701-4058 <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />AUTHORIZED REPRESENTATIVECJ <br />�+ <br />leztlice LRIJ[��GGGd 1 <br />91988-2018 ACORD CORPORATION, All rights reserved. <br />ACORD 26 (2018/03) The ACORD name and logo are registered marks of ACORD <br />