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ACUR ® CERTIFICATE OF LIABILITY INSURANCE <br />OAT7172 D/VYYVI <br />nz/zozo <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(les) 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 endorsement(_), <br />Marsh Risk and Insurance Services <br />345 California Street <br />CONPRODUCER <br />NAME: _ Marsh Risk and Insurance Services <br />PHONE Fall 415-743•e000 PAc <br />Suite 1300 <br />San Francisco, CA 94104 <br />D DRESS, <br />INBURER(b)AFFORONJO COVERAGE NAICN <br />INSURER A: XL Insurance America Inc. 24554 <br />www.marsh.com California License: 0H01556 <br />INSURED <br />Kappsch TrafficCOm Holding II US Corp. <br />8201 Greensboro Drive <br />Suite 1002 <br />INSURER so Travelers Property Casualty CO of Amer 25674 <br />INSURER C: ACE American Insurance Company 22667 <br />INSURER D: Charter Oak Fire Insurance Company 25615 <br />INSURERE: <br />McLean VA 22102 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 56414149 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 TYPE OFINSURANCE <br />Kam <br />POLICY NUMBERIT. <br />POLICY EFF <br />POLICY E%P LIMITS <br />A / COMMERCIAL GENERAL LABILITY <br />USOOIO1335LI20A <br />7111211211 <br />711/21121 EACH OCCURRENCE a1010000 <br />CLAIMS -MADE 7 OCCUR <br />PREMISES Ea ocollli 100,000 <br />MED EXP (Any ona parwo) S 10 000 <br />PERSONALSADVINJURY S1000,000 <br />GEN1 AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE s2,000,000 <br />POLICY � JECT 7 LOD <br />PRODUCT_ - COMPIOP AGG f 2 000 GOO <br />OTHER' <br />I <br />Deductible f100000 <br />B AUTOMOBILE LIABILITY <br />610-1 N626414 7/1/2020 <br />1 7/1/2021 Ea aBEO me BIN LI I <br />$1 000 000 <br />S <br />ANY AUTO <br />eODILV INJURY(Perparaon) <br />f <br />OWNED F7 SCHEDULED <br />6GDILY INJURY (Paraaklenq <br />_ AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />- <br />PROPER DAMAGE <br />f <br />AUTOS ONLY AUTOS ONLY <br />IPer erddeM <br />f <br />_ <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCE <br />S <br />f <br />EXCESS LIAR <br />CLAIMS -MADE <br />''i <br />_AGGREGATE <br />LIED RETENTIONS <br />f <br />D WORKERS COMPENSATION <br />[NIA <br />UB-OL200865 7/1/2026 <br />7/1/2021 ER oTK <br />J �gTATVTE ER <br />_ <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETONPARTNEWEXECUTIVE <br />E. L. EACH ACCIDENT <br />$1,000,000 <br />(M.ndst.I 1. NH)EXCLUDED7 �N <br />E L. DISEASE - EA EMPLOYEE <br />$ <br />51000000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />EL DISEASE - POLICY LIMIT <br />C Tech E80 - Professional Liability <br />G25604635004 <br />7/1/2020 <br />7/1 021 $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1ACORD 101, Additional Remarks Scbd.Ile, may M attached it mom space Is reeulrod) <br />Re- Agreement A-2019-203 <br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are Included as additional Insured (except for Workers <br />Compensation) on a primary noncontributory basis where required by written Contract. Waiver of Subrogation Is applicable in favor of City of Santa Ana <br />on General LiabilityAuto Liability, and Workers Compensation where required by written contract. <br />Policies include 30 Days' Notice of Cancellation with 10 Days' Notice for Non -Payment of Premium In accordance with the policy provisions. <br />REVIEWED & APPROVED <br />City of Santa Ana <br />Risk Management Division, 4th Floor <br />20 Civic Center Plaza — <br />Santa Ana CA 92702 F <br />20 2020 SHOULDEXPIRATION DATE TV DAE THEREOF, NOTICEDESCRIBED ES BE WILL CBE CELLED BEFORE <br />DELIVERED IN <br />I AL n ACCORDANCE WITH THE POLICY PROVISIONS. <br />SACORD <br />reserved. <br />ACORD 25 (2016103) <br />The ACORD name and logo are registered marks of ACORD <br />56414149 1 2e-Zl CL/AU/UKB;WC/Prcr S2K I At. Rush 1 712120tO 2:23:45 PH (COT) I Paac I cf 2 <br />