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ACORO CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMMD/YYYY) <br />F <br />1 01/23/2020 <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 endorsement(s). <br />PRODUCER <br />CONTACT <br />Kimberely Kelley <br />Insurance Solutions <br />PHG No Est: (949) 348-7400 ac Not (949) 348-2373 <br />License#0746539 <br />AouReSs: Kiml< ins-solutions.00m <br />33302 Valle Rd, Suite 200 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />San Juan Capistrano CA 92675 <br />INSURER A: Ohio Security Ins. Co. <br />24082 <br />INSURED <br />INSURER B: Allmenca Financial Benefit <br />41840 <br />Professional Sports Field Maintenance, Inc <br />INSURER C: American Fire and Casualty Company <br />24066 <br />29466 Ridge Rd <br />INSURER 0: <br />INSURER E: <br />San Juan Capistrano CA 92675 <br />INSURER F: <br />COVERAGES CERTIFICATE NIIMRFR• iB-20 All ocinnnu unsmve. <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />AIJUL <br />1 <br />UUMNPOLICY <br />yyyp <br />POLICY NUMBER <br />EFF <br />MMIDD/YYYY <br />POLICY EXP <br />MM0D/YYyyI <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000.000 <br />CLAIMS -MADE I l OCCUR <br />PREMISES Ea occurrence <br />$ 500,000 <br />MED EXP Any one person <br />$ 15,000 <br />PERSONAL B ADV INJURY <br />$ 1,000,000 <br />A <br />BKS59328473 <br />11/01/2019 <br />11/012020 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />X POLICY D JECT F1 <br />GENERALAGGREGATE <br />$ 2,000,000 <br />LOC <br />PRODUCTS-COMP/OPAGG <br />$ 2.000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />ANYAUTO <br />X <br />BODILY INJURY (Per person) <br />$ <br />B <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />AW3D995243 <br />07/26/2019 <br />07/26/2020 <br />BODILY INJURY Per accident) <br />$ <br />X <br />HIRED NON-0WNED <br />AUTOSONLY AUTOS ONLY <br />PROPERTYDAMAGE <br />Peraccident <br />$ <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 2,000,000 <br />AGGREGATE <br />$ 2,000,000 <br />C <br />EXCESS LIAR <br />I ICLAIMS-MADE <br />USA59328473 <br />11/01/2019 <br />11/01/2020 <br />OLD <br />I X1 RETENTION $ 0 <br />$ <br />WORKERS COMPENSATION <br />OTH- <br />AND EMPLOYERS' LIABILITY YIN <br />UTE ER <br />EACH ACCIDENT <br />$ 1,000,000 <br />A <br />ANY OFFICERIMEM ER EXCLU EO EcurME ❑ <br />NIA <br />XWS59328473 <br />10130/2019 <br />t0130/2020 <br />SE -EA EMPLOYEE <br />7E.L.DISEASE <br />$ 1,000,000 <br />(Mandatory In NH) <br />If yes, describe under <br />-POLICY LIMIT <br />$ 1, 000,000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101,Addlttonal Remarks Schedule, may be attached If more space is required) <br />The City of Santa Ana, it's officers, employees, agents, and representative are included as additional insured per the attached endorsement. <br />thirty day notice of cancellation - 10 day notice for nonpayment premium REVIEWED & APPROVED <br />By Risk ANAfiEMENT DIVI510N <br />DATE <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana, Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana CA 92701 I C.�aw <br />©1988.2015 ACORD CORPORATION_ All rinhte <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />