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Francine R. r'9'm'""gned byantlne
<br />Villareal °9e1030 80° 12""'
<br />ACORO® CERTIFICATE OF LIABILITY INSURANCE
<br />�i.
<br />DATE(MMIDDIYYYY)
<br />7/27/2020
<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 />HUB International Insurance SerVICES Inc.
<br />3636 American River Drive, Suite 200
<br />Sacramento CA 95864
<br />CONTACT
<br />NAME: ROCIo Leon
<br />AIONNo Exl: 916-4BO-4134 FAX
<br />No:916-993-7234
<br />E-MAIL
<br />ADDRESS: Rocio.Leon@hubinternational.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIL#
<br />INSURERA: Greenwich Insurance Company
<br />22322
<br />License#: 0757776
<br />INSURED WAREDIS-02
<br />Ware Disposal Inc.
<br />P.O. Box 1318
<br />INSURER B: Westchester Surplus Lines Insurance Co.
<br />10172
<br />INSURER C: Alaska National Insurance Company
<br />38733
<br />INSURER D: Indian Harbor Insurance Company
<br />36940
<br />Santa Ana CA 92702
<br />INSURER E
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 278481332 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 />R
<br />TYPE OF IN SURANCE
<br />ADDL
<br />MD
<br />POLICYNUMBER
<br />YEFF
<br />MMIDDYYYY
<br />POLICY EXP
<br />MMIDDYYYy
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />V
<br />GEC3000730-05
<br />2/28/2020
<br />2/28/2021
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS -MADE 1XI OCCUR
<br />PREMSREIFID
<br />ES Eeoccomence
<br />$100,000
<br />X
<br />MED EXP(Any one person)
<br />$5,000
<br />$1, 000 PD Ded.
<br />Per Occurrence
<br />PERSONAL&ADVINJURY
<br />$1,000,000
<br />GEML
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />Fyl
<br />POLICY PEO LOC
<br />PRODUCTS - COMP/OP AGO
<br />$2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />y
<br />AECO04538605
<br />2/28/2020
<br />2/28/2021
<br />COMBINED SINGLE LIMIT
<br />Ea accident)
<br />$1,000,000
<br />X
<br />BODI LV I NJURV(Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accitlent)
<br />$
<br />Per accitlent
<br />$
<br />HIRED NONOWNEDPROPERTVDAMAGE
<br />AUTOS ONLY AUTOS ONLY
<br />BI/PD Deductible
<br />$10,000
<br />B
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />G46863306003
<br />2/28/2020
<br />2/28/2021
<br />EACH OCCURRENCE
<br />$10,000,000
<br />X
<br />AGGREGATE
<br />$10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DIED RETENTION $
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERSLIABILITY YIN
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />20H WS 05450
<br />8/1/2020
<br />8/1/2021
<br />X PER OTH-
<br />STATUTE ER
<br />EL EACH ACCIDENT
<br />$1,000,000
<br />OFFICER/MEMBEREXCWDED9 N
<br />N/A
<br />EL DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mlnfail in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS brow
<br />EL DISEASE -POLICY LIMIT
<br />$1,000,000
<br />D
<br />Pollution &Remediation Legal
<br />PECO056139
<br />2/28/2020
<br />2/28/2023
<br />Each Poll. Condition
<br />$5,000,000
<br />Liability/CPL
<br />Aggregate
<br />$10,000,000
<br />Retention
<br />$10,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, A#tliti onal Remarks Schindel e, may be atta chef if more space is required)
<br />(General Liability Per Project Aggregate applies per written contract)
<br />RE: Work performed by the insured for certificate holder per written contract
<br />Additional Insured: City of Santa Ana; its officers, employees, agents, and representatives are additional insured with respect to General Liability and Auto
<br />Liability as required by contract.
<br />Forms: CG2010 0413, CG2037 0413, IX1405 0910, XIL431 0605, XIC411 1013
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATFIE
<br />Santa Ana CA 92701 „/j �—
<br />,SdPMlJ"< Risk ManagementDiuiaian
<br />+�REVIEWED&APPROVED BY:
<br />©1988-2015 ACORD `�9�IiLllJC1`
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD '®' Nick Management Analyst
<br />
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