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WISECAC-Cl
<br />TAIDAMS
<br />D01129/202ATE YY)
<br />01129/2020
<br />ACORO CERTIFICATE OF LIABILITY INSURANCE
<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 endorsements .
<br />PRODUCER
<br />C NTACT
<br />Bolton COmppany
<br />3475 E. Foothill Blvd., Suite 100
<br />PHONE FAX
<br />AIC, Ne,EA: 626 799-7000 Arc, No: 626 441-3233
<br />AI r0 Casual boltonco.com
<br />.&
<br />Pasadena, CA 91107
<br />IN AFFORDING ERAGE
<br />MAIC S
<br />IN RER A:Philadelphia lnsuranceCom n
<br />23850
<br />INSURED
<br />INSURER a: New York Marine & General Ins. Co.
<br />16608
<br />IN25URER C :
<br />Wiseplace, CA Corp. Wise Silver Center dba
<br />INSURER D
<br />1411 N. Broadway
<br />Santa Ana, CA 92706
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NIIMRFR- RFVISInN 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 />IM IR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INAID
<br />SUER
<br />POLN:Y NUMBER
<br />POLICY EFF
<br />POLICY EXPJZL
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADEEK OCCUR✓
<br />✓
<br />/DAMAGETO
<br />✓
<br />EACH OCCURRENCE
<br />1,000,000
<br />RENTED
<br />100,000X
<br />MED EXP (Any one ,son
<br />5,000
<br />PERSONAL B ADVINJURY
<br />S 1,000,000
<br />NL AGGREGATE LIMIT APPLIES PERGENERALA
<br />POLICY�JECT �LOC
<br />RELATE
<br />21000,000
<br />PR OUCTS-COMPIOP AGG
<br />2AOO,000
<br />SEXUAL PHYSICAL
<br />s 110001000
<br />OTHER
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />11000,000
<br />BODILY INJURY IPW
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />IA{UpT�O�S ONLYMNALTIFOSSWry
<br />AUTOSONLY AUTOSONLY
<br />PHPK2080191
<br />0110MO20
<br />01101/2021
<br />`�
<br />BODILY INJURY P 1
<br />X
<br />O,%RZl AAaGE
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />1,000,000
<br />AGGREGATE
<br />EXCESS LIAB
<br />CIAIMS-MADE
<br />PHUB706685
<br />01/01/2020
<br />01/01/2021
<br />DEL) X RETENTIONS 10,000
<br />Personal & Adv
<br />11000,000
<br />1
<br />B
<br />WORKERS COMPENSATION
<br />ANY EMPLOYERS'LIABILITYyyyy////yyyy
<br />/nr�FFICERIMEXCLUDED? u
<br />WLJE PRIETORI EXCLUDED?
<br />`—�mt� uhc
<br />X ,desoiee under
<br />IPT N OF QPERATIONSbebw
<br />NIA
<br />C201900006833
<br />08/15/2019
<br />✓
<br />0811512020STATU"
<br />��
<br />�( PER ERR
<br />EACH AIDENT
<br />11 1,000,000
<br />ISEASE - EA EMPL YE
<br />1,000,000
<br />DI EASE -PO YUMIT
<br />1,000,000
<br />A
<br />Pr ssional Liabili
<br />PHPK1924744
<br />7 till
<br />01 020
<br />Each OCCUrence
<br />1,000,000
<br />A
<br />Crime
<br />PHPK11924744
<br />01101/2019
<br />01/01/2020
<br />Aggregate
<br />2,000,000
<br />✓
<br />✓
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is rpulred)
<br />GL Additional Insured applies per CG20130413 attached, only If required by writte contractlagreement.
<br />Primary and Non -Contributory Wording applies per PIGLOO50712 attached.
<br />Notice of Cancellation applies per ILD0171198 attached,
<br />Additional insured(s): Cify of Santa Ana, Its officers, employees, agents, volunteers and representatives.
<br />RE: Operations of the named Insured.
<br />By
<br />City of Santa Ana
<br />Rish Management Division
<br />20 Civic Center Plaza, 4th floor
<br />Santa Ana, CA 92701
<br />MANAGEMENT D1 ISION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />ieR 9,11 �n�n ACCORDANCE WITH THE O ICYTHEREOF,TION DATE PROVISIONS.
<br />WILL BE DELIVERED IN
<br />RIZED REPRESENTATIVE
<br />ACEVEdO
<br />L�
<br />ACURU 25 (2016103) 01988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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