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THEAM-1 OI?11),
<br />,a►coR>o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br />�� 09/26/2019
<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 760-729-1143 PgDJACT Eric Dirk
<br />Tague Insurance Agency PHONE 760-729-1143 FAX 760-729-8617
<br />150 E Broadway Ste A AIC, No,
<br />EXI : �Nc, Nod:
<br />Vista, CA 92084-6068 eirledStagueins.corn
<br />Steven Tague
<br />INSURED The Amergroup, Inc.
<br />DBA American Security Group
<br />980 Park Center Dr J
<br />Vista, CA 92081
<br />INSURER F :
<br />Arch Insurance Company 11150
<br />The Hartford 29424
<br />Mapfre Insurance Company 23876
<br />COVFRAGFS CFRTIFICATE 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 />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE' OCCUR
<br />BAPKGO024105
<br />07/31/2019
<br />07/31/2020
<br />EACH OCCURRENCE
<br />1,000,000
<br />DAMAGE TO RENTED$
<br />100,000
<br />MED EXP Anyone person)
<br />$ 5,000
<br />$ 1,000,000
<br />NAL & ADV INJURY
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />I l
<br />X POLICY u JECT LOC
<br />000
<br />2,000,—
<br />GEN RAL AGGREGATE
<br />-F'-.--_.... .
<br />PRODUCTS=C MP! AG
<br />$OTHER 2,000,000
<br />2,500
<br />ded
<br />C
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Eaaacfrker if
<br />$ 1,000,U00
<br />BODILY NJU Y. Per person)$
<br />ANY AUTO
<br />8004010005357
<br />02/07/2019
<br />02/07/2020
<br />BODILY INJURY Per accident)$
<br />OWNED SCHEDULED
<br />AUTOS ONLY %� AUTOS
<br />Ix
<br />PeraE�,,iRdT�DAMAGE
<br />Ep
<br />AURTOSONLY X AUTOS ONLY
<br />A
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />CH C ENCE
<br />5,000,000
<br />$ 5,000,000
<br />X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />BAFXS0016705
<br />07/31/2019
<br />07/31/2020
<br />DED RETENTION $
<br />-AGGREPATE
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? Fy]
<br />(Mandatory In NH)
<br />N / A
<br />72WECAC6L88
<br />01/21/2019
<br />01I21I2020
<br />X 1PER OTH-
<br />LEACHA ACCIDENT
<br />$ 1,000,000
<br />EL_ DISEASE - EA EMPLOYEE
<br />1,000,000
<br />L E- P LI Y LIMIT
<br />1,000,000
<br />If yes, describe under
<br />DESC IF ON OF
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space isBy-Iftk MANAGEMENT DIVISION
<br />City of Santa Alta, Risk Management, its officers, employees, agents,
<br />representatives & volunteers are named as additional insured, coVeragae is � � 201
<br />primary & non-contributory and waiver of subrogation apply per attached 1
<br />endorsements. /n ? � 4LK_
<br />F ANCINE R. VILLAREAL
<br />DER
<br />CITY081
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza 4th FI
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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