|
Digitally signed by Francine R.
<br />Francine R. Villareal Villareal
<br />Date: 2021.04.29 1$v3gPD2'k' of 2
<br />AC Ram CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(M/2021
<br />04/27/2021
<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 />Willis Towers Watson Northeast, Inc.
<br />c/o 26 Century Blvd
<br />P.O. Box 305191
<br />CONTACT Willis Towers Watson Certificate Center
<br />NAME:
<br />PHONE 1-877-945-7378 F' 1-888-467-2378
<br />A/C No Ext : A/C, No :
<br />E-MAIL cm
<br />ADDRESS:ertificates@willis.co
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />Nashville, TN 372305191 USA
<br />INSURERA: Hartford Fire Insurance Company
<br />19682
<br />INSURED
<br />Digital Map Products, L.P.
<br />5201 California Avenue, Suite 200
<br />INSURERB: Trumbull Insurance Company
<br />27120
<br />INSURERC: Hartford Casualty Insurance Company
<br />29424
<br />INSURERD: Hartford Accident and Indemnity Company
<br />22357
<br />Irvine, CA 92617
<br />INSURERE: Indian Harbor Insurance Company
<br />36940
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: W20738935 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 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 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 />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />x
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE � OCCUR
<br />DAMAGEl(RENTED
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />A
<br />Y
<br />10 UUN HF7379
<br />04/05/2021
<br />04/05/2022
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />POLICY ❑ PRO ❑
<br />JECT LOC
<br />x
<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 />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />10 UUN HF7379
<br />04/05/2021
<br />04/05/2022
<br />BODILY INJURY (Per accident)
<br />$
<br />x
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED x NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />C
<br />x
<br />UMBRELLA LAB
<br />x
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />IOXHUHF6110
<br />04/05/2021
<br />04/05/2022
<br />DED x RETENTION $ 10,000
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N
<br />OFFICER/MEMBER EXCLUDED? No
<br />(Mandatory in NH)
<br />N/A
<br />10 WE AB2QX4
<br />04/05/2021
<br />04/05/2022
<br />x PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />E
<br />Cyber Liability
<br />MTP9039876 01
<br />10/29/2020
<br />10/29/2021
<br />Each Incident/Agg
<br />$10,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />This Voids and Replaces Previously Issued Certificate Dated 04/09/2021 WITH ID: W20675041.
<br />RE: All Covered Operations
<br />ADDITIONAL NAMED INSURED: LightBox Holdings, L.P., LightBox Intermediate Holdings, L.P., LightBox Intermediate, L.P.,
<br />LightBox Parent, L.P., LightBox Employer, L.L.C., Digital Map Products, L.P., DMTI Holdings, L.P., EB Holdco LLC,
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF,
<br />NOTICE WILL
<br />BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Santa Ana
<br />Risk Management Division
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza, 4th Floor
<br />oRa
<br />RAMwagamentDMsian
<br />Santa Ana, CA 92701
<br />REVIEWED &APPROVED BY.-
<br />© 1988-2016 ACORD C
<br />Y
<br />ACORD 25 (2016103)
<br />The ACORD name and logo are registered marks of ACORD
<br />Risk Management Analyst
<br />SR iD: 21023734 BATCH: 2072628
<br />
|