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__1_044 GENEPUM-01
<br />oA812712M'
<br />'`� CERTIFICATE OF LIABILITY INSURANCE
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provislons 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 License d 0757776
<br />_
<br />c ACT Sherri Ben -Nun
<br />HUB International IOSUrflnC@ Services Inc.
<br />16030 Ventura Blvd., Suite 500
<br />Encino, CA 91436
<br />PHONE A%
<br />nfc, N E 818 257.7438
<br />-MA . sherrLbennum@1buthintannational.com _
<br />INO URE%M AFFORDING GE Oa
<br />�._......._.__.
<br />INSURER A Travelers Property Casualty Com n Df America
<br />25674
<br />INSURED
<br />INSURER s •The Travelers Indemnity Company of Connecticut
<br />25682
<br />Iliggilra q;As gn S paClaIWInsurance
<br />10717
<br />General Pump Company, Inc.
<br />INSURER D:
<br />159 N. Acacia Street
<br />San Dimas, CA 91773
<br />INPURER'—
<br />INSURER F:
<br />Eli
<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 CONTRACTOR 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 />I�
<br />TYPEOFINSURANCE
<br />POLICYNUMBER
<br />POUCYEFF
<br />POLICYE%P
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERAL LIABILM
<br />CIAIMSlAADE [X�occuR
<br />X
<br />30.71<939062-TIL-19
<br />611/2019
<br />6/112020
<br />ENCE
<br />11000,000
<br />DAMADET(r RENIEO
<br />100,000
<br />MED P A — emon
<br />S 6,000
<br />X
<br />— — -------
<br />NLAGGREGATE LqIIMpIIT. APPLIES PER:
<br />POLICY jEDT LOC
<br />OTHER
<br />PERECINALAA,DVLwURY
<br />1.000.000
<br />L REDATE
<br />S 2,000,000
<br />pUCT - 40
<br />2,000,000
<br />A
<br />AUTOMOa
<br />X
<br />LIABIUW
<br />ANY AUTO E�
<br />IAAI{M�pOVYTT�0.�4DONLY AA(��QpSµULNEEDp
<br />AIJTQS ONLY AUTOS ONLY
<br />10-ON810047.19-CAD
<br />G11120111
<br />6/1/2020
<br />LOSINGLEUNIT
<br />U Per eman
<br />11 1,000,000
<br />Y[iWJU�RYM(AP�uEerdd I
<br />Ofni
<br />rYeraul
<br />B
<br />X
<br />UMBRELLA LIAR
<br />EXCESS UAB
<br />I X
<br />11 OCCUR
<br />CI_NMS-MADE
<br />UP-1 N325166.19.14
<br />611/2019
<br />6/1/2020
<br />EACH QCCORRENCli4,000,000
<br />AGGREGAre
<br />4,000, 00
<br />DED RETENTIONS
<br />A
<br />WWODRKERS COO ''WBNT'
<br />ANY PROPRIETORIPARTNERUFJfECUTIVE YIN
<br />gqF�FIC�ER/MF1M�R EI(CWDED'! ❑Y
<br />Iman story n
<br />11 a, desadbe ewer
<br />I Calm
<br />NIA
<br />B-7K940269-TIL-19
<br />61112019
<br />6/112020
<br />X PER
<br />D N
<br />000,0(k 1,
<br />L. ISEAS -
<br />1,000,000
<br />1,000,000
<br />C
<br />Pollution Liability 9
<br />AHL9619
<br />21512019
<br />215/2020
<br />Each Incident
<br />1,000,000
<br />OESCRWl10N OFOPERAl10N3llOCAiWN3IVEHICLE9 SACOR0 tat, Addtlansl Ramahs 5ctad.w ma, be aaacead a mmayww Wnq.wdl
<br />Whore required by Written Contract, the City Df J@Rta Ana, Its officers, employees, agents, and mpresentath es ere included as Additional Insured as respects
<br />operations of the Named Insured as their Interest may appear per the attached #CG D2 46 04 19. Coverage Is primary and non-aantributory per Form CGD246
<br />0419 and #CGT100 02 09, page 16, paragraph 4. 30 Days Cancellation except 10 Days for Non -Payment
<br />REVIEWED & APPROV
<br />By Risk MANACIEMENT DIVIS
<br />SHOULD ANY OF THE ASO
<br />City of Santa Ana THE EXPIRATION DATE Risk Management Division, 41h Floor ACCORDANCE WITH THE F
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702 1 AUTHORIZED REPRESENTATIVE
<br />25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
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