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Francine R. D',°"'� edby Raclue <br />R.Vllh,eel <br />Villareal Dace: 2020.08.0612:a932 <br />ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />DATE 6(/71/DD/YYYY) <br />sr3rzozo <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 />Assured Partners I Hall & Company <br />A/E Insurance Services <br />1966010th Ave NE <br />CONTACT <br />NAME: Theresa Swanson CA#ON1416 <br />PHONE FAX <br />A/c No Ext: 360-626-2957 Alc No:360-626-2957 <br />ADDRESS' theresa.swanson@assuredpartners.com <br />INSURER(S)AFFORDING COVERAGE <br />NAIC# <br />Poulsbo WA 98370 <br />INSURERA: Beazley Insurance Company Inc <br />37540 <br />INSURED SAGEPLA-01 <br />Sagecrest Planning+Environmental <br />2400 E Katella Ave Suite 800 <br />INSURER B: Travelers Property Casualty Company of America <br />25674 <br />INSURER C: <br />INSURER D: <br />Anaheim CA 92806 <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 1837766029 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 />OF INSURANCE <br />ADDLSUBRTYPE <br />INSO <br />WID <br />POLICYNUMBER <br />EFF <br />MM/DDIWW <br />EXP <br />POLICYPOLICY <br />MMIDDYYYY <br />LIMITS <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />6805,1742889 <br />6/1/2020 <br />6/1/2021 <br />EACH OCCURRENCE <br />$2,000,000 <br />Cl-AIMS-MADE 1XI OCCUR <br />DAMAGE PREMISES Ea occurrOence <br />$1,000,000 <br />MED EXP(Any one person) <br />$5,000 <br />PERSONAL&ADV INJURY <br />$2,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$4,000,000 <br />Fyl POLICY PEP LOC <br />PRODUCTS-COMP/OP AGO <br />$4,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />6805,1742889 <br />6/1/2020 <br />6/1/2021 <br />COMBINED SINGLE LIMIT <br />Ea accident) <br />$2,000,000 <br />BODI LV I NJURY(Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTO$ONLY AUTO$ <br />BODI LY I NJURV(Per accident) <br />$ <br />X <br />HIRED N NON -OWNED <br />AUTO$ ONLY AUTO$ ONLY <br />PROPERTY DAMAGE <br />Per accitlenl <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />UB5J743745 <br />6/1/2020 <br />6/1/2021 <br />X PER DTH- <br />STATUTE ER <br />ANYPROPRIETOMPARTNER/EXECUTIVE <br />EL EACH ACCIDENT <br />$1,000,000 <br />OFFICER/MEMBEREXCLUDED9 ❑ <br />N/A <br />E. L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />I <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />A <br />Professional Liab;Cours Made <br />V1 EEB6200301 <br />6/1/2020 <br />6/1/2021 <br />PerClaim <br />2,000,600 <br />Aggregate <br />4,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />The City of Santa Ana, It's Officers, Employees, Agents and Representatives are named as Additional Insured on the Commercial General Liability and Auto <br />Liability when required by written contract or agreement regarding activities by or on behalf of the Named Insured. The Commercial General Liability insurance <br />is primary insurance and any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance. A waiver of <br />subrogation applies to the Commercial General Liability, Auto Liability and Workers Compensation / Employers Liability in favor of the Additional Insured. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />REPRESENTATNE <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Risle Mrsnaganent Diaisian <br />ram. <br />REVIEWED &{APPRovED By., <br />olllli111-1� /-z' rb6HlM�e VaRRE/t¢bl. <br />® Risk Management Analyst <br />