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ALA o® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MmmorfYYYj <br />01/22/2020 <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 />H 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 />CONTACT <br />NAME: <br />Hiscox Inc. d/bla/ Hiscox Insurance Agency in CA <br />PNONE (888) 202-3007 FAX <br />_ <br />520 Madison Avenue <br />�DREBy, contact@hiscox.com <br />32nd Floor <br />New York, NY 10022 <br />INSURERS AFFORDING COVERAGE <br />time <br />INSURERA: Hiscout Insurance Company Inc <br />10200 <br />INSURED <br />INSURER B <br />Steven Hernandez dba Water Wise Pro <br />1521 Memorial Drive <br />INSURER C <br />INSURER D : <br />Apt, G <br />INSURER E <br />Hollister, CA 95023 <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 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 />OF INSURANCE <br />ADDLTYPE <br />J= <br />BURR <br />im <br />POLICY NUMBER <br />MM(POLICY EFF <br />MOO OrICY UPLIMITS <br />x <br />COMMERCIALGENERALLIABILITY <br />EACHOCCURRENCE <br />$2,000,000 <br />CLAIM&MADE 1XI OCCUR <br />PREMISES E. .I <br />s 100,000 <br />MEDEXP onsperson) <br />s 5.000 <br />PERSONAL S ADV INJURY <br />s2,DD0,DD0 <br />A <br />N <br />Y <br />UDC-1955669-CGL-19 <br />04/1812019 <br />04/18/2020 <br />GENT <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />32,000,000 <br />X <br />POLICY ECT 7 LOC <br />PRODUCTS - COMPIOP AGO <br />SSIT Gen. AQg <br />$ <br />OTHER: <br />AUTOMOBILE <br />COMBINED SINGLE LIMIT <br />iES accident) <br />$ <br />BODILY tNJURY (Per persanf <br />s <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Par amJden) <br />It <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />e .donl <br />Par <br />B <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />s <br />AGGREGATE <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DIED RETENTION 5 <br />S <br />WORKERS COMPENSATION <br />ANOEMPLOYERS'LASILfTY YIN <br />PER OTH- <br />STATUTE ER <br />ANYPROPRIETORIPARTNERIEXECUTIVE <br />E.L. EACH ACCIDENT <br />$ <br />OFFICERIMEMSEREXCLUDED? <br />MIA <br />E.L DISEASE - EA EMPLOYE <br />$ <br />frbndatory In NHj <br />If Yyaes, describe under <br />DESCRIPTION GF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPnON OF OKE nONS I LO nONS I VEHICLES (ACORD 1a1, AddiU naL Remy s Sehedule, may be atnched K mon apace is repair ) <br />City of Santa Ana, its officem. employees. agents, and representatives are named as additional insured. Specifically the City Water Division, who services will be given to. 30' Days <br />Notice of Cancellation with 10 Days' Notice for Non -Payment of Premium in Accordance with The Policy Provisions. Such Insurance as is afforded by the policy shall be primary, an <br />d any insurance tamed by City shall be excess and noncontributory. <br />CERTIFICATE HOLDER CANCELLATION <br />CITY OF SANTA ANA RISK MANAGEMENT D I ION 4T FLO <br />20 CIVIC CENTER PLAZA RE( b AROVED <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />SANTA ANA CA 92702 By ISk <br />N4GEMENT DIVISION <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />�J <br />O2U'U <br />AUTHORI2EDREPRESENTATIVE <br />yY. <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />