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A� " CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/WYY)
<br />10/25/2019
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT NAME: Charlene Dean
<br />TJS Insurance Group
<br />NCO NNo Ext: (412)395-4000 /iC NO; (412)381-9368
<br />E-MAIL ADDRESS: cdean@tjsins.com
<br />1301 Grandview Avenue,
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />Suite 400
<br />INSURER A: Federal Insurance Company
<br />20281
<br />Pittsburgh, PA 15211
<br />INSURED
<br />INSURER B
<br />INSURERC:
<br />Chemimage Corporation
<br />INSURER D:
<br />7325 Penn Avenue
<br />INSURER E:
<br />Ste 200
<br />INSURER F:
<br />Pittsburgh PA 15208
<br />COVERAGES CERTIFICATE NUMBER:CL1931617136 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />I NSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUERPOLICY
<br />VIVO
<br />POLICY NUMBER
<br />EFF
<br />MM/DD WYY
<br />MML ICY EXP
<br />DD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />CLAIMS -MADE ❑X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence)$
<br />1,000,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />35808757
<br />4/1/2019
<br />4/1/2020
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />X POLICY ❑ PRO -
<br />POLICY ❑ LOC
<br />PRODUCTS - COMP/OPAGG
<br />$ EXCLUDED
<br />Employee Benefits
<br />$ 1,000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />CEa aOM ccident BINED SINGLE LIMIT
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />`A
<br />ANYAUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />73242676
<br />4/1/2019
<br />4/1/2020
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />NON -OWNED
<br />HIRED AUTOS M AUTOS
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />Uninsured/Underinsured Mot
<br />$ 1,000,000
<br />X
<br />UMBRELLA LAB
<br />X]t
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />A
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $ 0
<br />$
<br />79781737
<br />4/1/2019
<br />4/1/2020
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />X PER OTH-
<br />STATUTE ER
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT
<br />$ 500,000
<br />A
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH) ❑
<br />N /A
<br />71648805
<br />4/1/2019
<br />4/1/2020
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 500,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 500,000
<br />A
<br />PRODS LIABILITY -CLAIMS MADE
<br />35808747
<br />4/1/2019
<br />4/1/2020
<br />PRODUCTS LIABILITY $5,000,000
<br />A
<br />ERRORS&OMISSIONS-CLAIMS MAD
<br />35808747
<br />4/1/2019
<br />4/1/2020
<br />ERRORS & OMISSIONS $10,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: VeroVision Mail Screener and the Adoni ConPass DV Dual View Full Body Security Screening System
<br />City of Santa Ana, its officers, employees, agents, volunteers, and representatives are named as
<br />Additional Insured with respects to General Liability on a Primary and Non -Contributory basis. 30 day
<br />notice of cancellation applies. Umbrella is follow form.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Risk Management Division
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />4th Floor
<br />Santa Ana, CA 92702
<br />Charlene Dean/CLD
<br />ACORD 26 (2014101)
<br />INS025 (201401)
<br />© 1988-2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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