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i4C a� CERTIFICATE OF LIABILITY INSURANCE <br />OATE(MMDD)YYYY) <br />02/24/2020 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br />AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not <br />confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />BIZINSURE LLC/PHS <br />57102005 <br />The Hartford Business Service Center <br />NAME' <br />PHONE (866)467-8730 <br />(A/C, No, skill: <br />FAX (888)443-6112 <br />(AIC, No): <br />3600 Wiseman Blvd <br />E-MAIL <br />San Antonio, TX 78251 <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAICN <br />INSURED <br />INSURER A: Twin City Fire Insurance Company <br />29459 <br />Hall Aquatic Life Support Designs DBA Hall Aquatic Design LLC <br />INSURER B : Hartford Accident and Indemnity Company <br />22357 <br />347 GRANT ST SE <br />INSURER C : <br />ATLANTA GA 30312-2226 <br />INSURER D <br />INSURER E : <br />INSURER F : <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 />INDICATEDMOTWITHSTANDING 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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />WVO <br />POLICY NUMBER <br />POLICY EFF <br />IDO <br />POLICY EXP <br />M/DD/Y YYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE -OCCUR <br />General Liability <br />DAMAGE TO RENTED <br />PREMISES Ea o rence <br />$1,000,000 <br />X <br />MED EXP (Any one person) <br />$10,000 <br />A <br />X <br />57 SBM BL2522 <br />11/09/2019 <br />11/09/2020 <br />PERSONAL&ADV INJURY <br />$2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER; <br />GENERAL AGGREGATE <br />$4,000,000 <br />POLICY PRO- ECT X LOG <br />PRODUCTS - COMP/OP AGG <br />$4,000,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$2,000,000 <br />BODILY INJURY (Per person) <br />ANY AUTO <br />A <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />57 SBM BL2522 <br />11/09/2019 <br />11/09/2020 <br />BODILY INJURY (Per accident) <br />X <br />HIRED NON -OWNED <br />AUTOS X AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CLAIMS- <br />MADE <br />AGGREGATE <br />DEO RETENTION $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />X <br />PER <br />STATUTE <br />OTH- <br />E <br />F.L. EACH ACCIDENT <br />$1.000,000 <br />ANY YIN <br />B <br />PROPRIETORIPARTNEWEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />57 WEC AC3MZN <br />11/09/2019 <br />11/09/2020 <br />F.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />A <br />EMPLOYMENT PRACTICES <br />LIABILITY <br />57 SBM BL2522 <br />11/09/2019 <br />I <br />11/09/2020 <br />I <br />Each Claim Limit <br />Aggregate Limit <br />$10,000 <br />$10,000 <br />DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 101, Addifional Remarks Schedule, may be attached U more space is required) <br />Those usual to the Insured's Operations. <br />CERTIFICATE HOLDER 01-VIEWED Qk CANCELLATION <br />City of Santa Ana By R151( ANAgEM <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />Risk Management Division <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />20 CIVIC Center Palaza, 4th Floor 1lD <br />"frVl�'� <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />PORTLAND OR 97202 <br />CI 1�r CCiO <br />ACORD 25 (2016103) <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />