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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DONYYY) 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: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 riahts to the n.rfiicato hmAl I. Ile.. PRODUCER SilverStone Group 11516 Miracle Hills Drive Suite 100 Omaha NE 68154 INSURED DMS Facility Services LLC DMS Facility Services Inc 1040 Arroyo Drive South Pasadena CA 91030 UUVICKALieS CERTIFICATE NUMBER: 1555272138 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 INSR _.____ BY PAID CLAIMS. - -- LTR TyPIEOF MMIpOYEFF �OLICYEXP ---_— --LIMITS --- --- POLICY NUMBER LGNERAL LIE B X COMMERCIAL GENERAL LIABWTY TB2-691.458727-089 101V2019 10/1/2020 EACH OCCURRENCE CLAIMS -MADE f OCCUR-BAMAGETONME--'— 51,000,000 O PREMISES,(Ee_nur occe].. _-S 100.000 ----- - --- MED EXP one arson PERSONAL B AUV INJURY $1.000_000 __ GEN'L AGGREGATE LIMITPRO. APPLIES PER: GENERALAGGREGATE $2,000,OG0 POLICY I JEST D LOC PRODUCTS •COMP/OP AGO $2,000.000 OTHER: $ C AUTOMOBILE LIABILITY AS6-691-458727-079 10/1/2019 10/1/2020 OMBINEDSINGLE UMn a tl,n E1,000,000 X ANY AUTO BODILY INJURY (Per Parana) $ — OWNED SCHEDULED .. AUTOS ONLY AUTOS HIRED NONAWNED BWILYINJURY(Perac dwu --- § AUTOS ONLY AUTOS ONLtRETEWIONS PROPERTYOAMAGE APS a900,dL $ UMBRELLA OCCUR EXCESS LIACLAIMS-MADE EACH OCCURRENCE __ E AGGREGATE § — OED --- --_— —' A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WA7-69D458727-059 10/1/2019 10/1/2020 X ST TUTE ANYPROPRIETOMPARTNEWEXECUTNE YIN OFFICERIMEMBEREXCLUDED7 NIA EL.EACH ACCIDEN00 (Mandatary In NH) EL. DISEASE -EA EDOCRIPTION ----- aWb.under E.L. DISEASE-POL00D Fi.003.0DO OF OPERATIONS below Contractors Pollution CPO1fi083fi93Liability 10/1/2019 10/1/2020 Each Loss000Aggregate000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 1a1, Additional R.mar9. Schadula, may be aBached II more .pace le required) Additional Insured on a primary and non-contributory basis wilh respects to General Liability, Including completed operators, as required by written contract: City of Santa Ana, Risk Managemenl, It's ofriGers, employees, agents, representatives, and volunteers. Waiver of Subrogation with respects to Workers Compensation as required by written contract. 30 days' Nollce of Cancellation provided with respects to General Liability, Auto and Workers Compensation as required by written contract. E I WM D &EMENTAPPRpOVEoD rPRTIPIrATG Mnt nco City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUNTATIVE THORIZED E4 REPR 011 C ......... 1 r,C •a umu name ano logo are registered marks of ACORD riahts