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A�Rh® CERTIFICATE OF LIABILITY INSURANCE <br />DAT0827/20019OI <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 INSURERS). 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 endorsemen s). <br />PRODUCER <br />COWACT Joey William, <br />Slade &Collins Insurance Agency <br />PHONE 859.2131121 FAX 859-219.1125 <br />Me): <br />3320 Clays Mill Road <br />_Lc, eo Eel- (AIC. <br />Suite 109 <br />: Jogt(3O SladeandCdlins.can <br />Lexington, KY 40503 <br />INSURERS AFFORDING COVERAGE N04C0 <br />INSURERA: Liberty Insurance <br />24082 <br />INSURED NA$BLA <br />INSURERS: Phoenixinsurance Company <br />25M <br />1648 MCGrathiana PlgvySte 360 <br />INSURER c: EVANSTON INSURANCE COMPANY <br />35378 <br />Lexington, KY 405111338 <br />INSURER D: <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INS(RANCE LISTED BELOW WAVE BEEN ISSUED TO THE INSURED WIVED ABOVE FOR TIE POLICY PERIOD <br />INDICATED. NDIWITHSTANDING ANY REOUREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH MS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NN <br />LTRPOLICY <br />TYPE OF INSURANCE <br />ADLIL:OUR <br />NI9ABER <br />POLICY OFF POUCY EXP <br />N YYY1 (MMUDCVYYYY11 <br />Liens <br />A <br />COMMERaALGERENA UAwUTY <br />CLAMS4ANDE � OCCUR. <br />Y <br />BKS57763682 <br />021DQ2D19 02/04/2020 <br />EACHOCCLRREL+CE <br />$ 1,000,000 <br />PREMSE'O HEATED <br />S Eaacaarerce <br />NED EJP (Aly orb Parapn) <br />$ 1,1100,000 <br />3 15,000 <br />PERSOLNL BADV VERY <br />S <br />GENL <br />AGGREGATE LIMIT APPLIES PER <br />POLICY ❑,ECT LOC <br />OTHER <br />GENERAL AGGREGATE <br />s 2,000,00D <br />PROIXICTS-COMP/OPAGG <br />$ ZDDo,000 <br />S <br />A <br />AurouomLE LABLm <br />NIY AUTO <br />VOVINE ONLY SCHEDULEDmBODILY <br />AUTOHIREAUPOSONlV MDNOO <br />AUT$ <br />Y <br />BKS57763682 <br />02ID4/2019 02/04/2020 <br />.Lae ED SIN <br />s 1,000.000 <br />BODLYNA.RYIPerpswn) <br />s <br />NASRV (Pa ew4ad) <br />s <br />PONLYPROPERTY DAMAGE <br />$ <br />UMBRELLA LAB OCCUR <br />EXCESS LAB CLAMS -MADE <br />EACH OCCURRENCE <br />s <br />AGGREGATE <br />$ <br />DED RETENTION s <br />$ <br />B <br />WORMERSCOMPEMSATION <br />AND EMPLOYERS UASILITY <br />ANY PRCPRIETORPARINEPoEJEOJnVE V I N <br />OFFICER/MEMBER EM1lAEV1 <br />(Mandatoryin MN) <br />r yyos. deeaile Drab <br />DESORIPTIONOFOPERATOSe <br />NIA <br />INUB4022T6W16 <br />12/04/2119 <br />12/0472020 <br />STATUTE <br />EL EACH ACCIDENT <br />$ 1,ODO,000 <br />EL DISEASE - EA EMPLOYEE <br />$ 1.�•� <br />EL DISEASE - POLICY LILT <br />s 1,000,000 <br />C <br />Professional Liability <br />E0973120 <br />092772DI9 09127/2M <br />Professional Liability <br />$1,000,1 <br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be cMached N moro space la required) <br />Cityof Santa Ana, officers, agents, employees, and wlun Leers are named as additionally insured on this policypursuant to written contract, agreement, or memorandum of <br />understanding. Such insurance as is afforded by this policy shall be primary, and any insurance Carried by Cityshall be eycess and noncontributory. <br />Insurance Carriers shall provide thirty(30) day prior written notice of cancellation <br />By RI5 <br />ANAGEMENT DI <br />SIOiWLILD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN <br />Cityof Santa Ana <br />19 �O�Nr <br />19 aJ <br />ACCORDANCE WRTH THE POLICY PROVISIONS. <br />RiskManagement Division <br />4SAAM <br />AUTHORIZED REPRESENTATIVE <br />20 Center Plaza 4th Floor <br />Santa A <br />santaAna.cAsz7ot <br />AM. IAMB <br />n•/.Jy'�'�`'/) <br />T �V <br />® 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />