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Digitally signed by Francine R. <br />Francine R. Villareal Villareal <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/M/DD1 YYYY) <br />9/7/2021 <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 on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />RBN Insurance Services <br />303 E Wacker Dr Ste 650 <br />IL 60601 <br />CONTACT <br />NAME: Tellsa Gibson <br />PHONE FAX <br />vC No Ext : 312-856-9400 A/c, No): 312-856-9425 <br />E-MChicago <br />ADDRESS: tgibson@rbninsurance.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURERA: Twin City Fire Insurance Co. <br />29459 <br />INSURED ESOURCE-01 <br />E Source Companies LLC <br />1745 38th St <br />INSURERB: Underwriters at Lloyds <br />11041 <br />INsuRERc: HARTFORD UNDERWRITERS INS CO <br />30104 <br />INSURERD: <br />Boulder CO 83301 <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER:255604206 REVISION NUMBER: <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 />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICYNUMBER <br />POLICY EFF <br />MM/DD <br />POLICY EXP <br />MM/DD <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />83SBAAD4682 <br />6/14/2021 <br />6/14/2022 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE OCCUR <br />PREMISES DAMAGE TO <br />PREMISES Ea occurrence) <br />ccurrence <br />$ 1,000,000 <br />MED EXP (Any one person) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />POLICY PRO ❑ LOC <br />El JECT <br />X <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />83SBAAD4682 <br />6/14/2021 <br />6/14/2022 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />X <br />PROPERTYDAMAGE <br />Per accident <br />$ <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />A <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />83SBAAD4682 <br />6/14/2021 <br />6/14/2022 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />AGGREGATE <br />$ 5,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X RETENTION $ 1 n nnn <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />Y <br />83WECAD4JDV <br />6/14/2021 <br />6/14/2022 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />OFFICER/MEMBER EXCLUDED? <br />N /A <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />B <br />Technology/Professional Liability <br />CT0146321 <br />6/14/2021 <br />6/14/2022 <br />Each Claim/Aggregate <br />5000000 each <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />Continued Coverage <br />Excess Professional/Cyber Policy <br />Policy: PS100190818262 <br />Carrier: Underwriters at Llyods <br />Effective: 06/14/2021 to 06/14/2022 <br />Limit: $5,000,000 each Claim/Aggregate <br />City of Santa Ana, The City, its officers, employees, agents, volunteers & representatives are listed as additional insured on primary and non-contributory basis <br />See Attached... <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, <br />NOTICE WILL <br />BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701 <br />1 <br />�oRaN <br />RiskMmRgementDMsian <br />r. <br />REVIEWED & APPROVED BY: <br />© 1988-2015 ACORD CltC+�e <br />JZ, (JAWAI <br />ACORD 25 (2016/03) <br />The ACORD name and logo are registered marks of ACORD <br />' <br />Risk Management Analyst <br />