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ACC)R kfts� O CERTIFICATE OF LIABILITY INSURANCE `4019 DATE(M10:23,2019 YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder In lieu of such endorsements . PRODUCER NAME: Lynette (Lynn) Eye Pbk Select Insurance Solutions AN: Na eaL: IROS) 975-3531 IMC. xoi: ADOREea: Iynn.c%ela.piaselecLcom I 100 Industrial Rd., e? INSURER($) AFFORDING COVERAGE NAIL e San Carlos CA 94070 INSURER A: AmCo Insurance Company 002014 INSURED INSURERS: Employcninsurancc Group 10346 Dam Ticket. Inc. INSURER C DBA: Revenue Experts INSURER D: LNSURER E: 2603 Main Street. Ste. 300 INSURER F: Irvine CA 92614 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE )NSO VIVD POLICY NUMBER IMMIDI1MYri) IMMIDOIYYYYI MWTe A X COMMERC GENERAL LIABILITY CLAIMS•41AOE OCCUR Y Y ACP BPO 3059509589 11 01 2019 It 01 20_0 EACH OCCURRENCE $ 2,000.000 PREMISES Ee ormrn,) S 300.000 MED EXP IMF ans Poison) 5 5.000 PERSONAL a AOV INJURY s Excluded G�ENL AGGREGATE LIMIT APPLIES PER: Aa POLICY �JEl6T ❑LOC OTHER OENERALAGGREGATE 4.000.000 PRODUCTS-COMPIOPAGG S 4,000,000 5 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOSONLY At1T03 HIRED NON-OWNEC AUTOS ONLY X AUTOS ONLY ACP BP030595095a9 ILD12019 II OL2020 IEa nizMPnr S 1,000.000 BODILY INJURY (Par Perron) 5 BODILY INJURY (Per ecci0an11 S Per actlden9 S 5 A '( UMBRELLA LIAR EXCESS ME I OCCUR ICLAIIS-MM)E ACP CAA 30i9509589 11,01,1019 11 01 2020 EACH OCCURRENCE S 3.000.000 AGGREGATE 5 2.000,000 DED I I RETENTIONS S B RIVE S YERS' S UT i,NNp EMPLOYERS' LIA&IJTY Y PROPRIETORPARTNEREXECUTIVE YIN FFICERAtEMSER EXCLUDEO> 5❑' Mandatory In NH) i yyeesa desomm under ESCRIPTION OF OPERATIONS bebw NIA 1' EIG_BG9443 O7I2Q019 0T 1220_0 X STATUTE ER EL EACH ACCIDENT 5 1.000,9W E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT S 1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddMenM Bamerks SCheduM, may ba amaahetl N mom sines Is Inquired) City of Santa Ana, officers, agents, employees. and volunteers are named as additional insured on the General Liability Policy pursuant to written contract, agreement or memorandum of understanding_ The General Liability policy includes a Waiicl of Subrogation. Primary & Non -Contributory wording and 30 day notice ofcancellation as required by written contract (see attached). Workers Compensation includes a blanket Waiver of Subrogation (see attached), CERTIFICATE HOLDER CANCELLATION REVIEWED By Risk City of Santa Ana &APPROVE NAGEMENT DIVISION THE EXPIRATION DATE THEREOF, NOTICE WILL BESHOULD ANY OF THE ABOVE DESCRIBED DELIVEREDIN BE BEFORE ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Ci.ic Center Plaara, 4th Floor 27 2019 AUTOO REDREPRESENTATIVE Si... Ana CA 92702 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD