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Digitally signed by Francine R. <br />Francine R. Villareal Villareal <br />Date.2020.09.21 14.00:48-0700' <br />ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDD YYYY) <br />9/15/2020 <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 />MHBT, a Marsh & McLennan Agency, LLC company <br />8144 Walnut Hill Lane, 16th FI <br />Dallas TX 75231 <br />CONTACT <br />NAME: Stacy Brlmer <br />PHONE FAX <br />AIL Ne Eat: LAIC No:972-376-8108 <br />ADDRESS: stacy_brimer@mhbt.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURERA: Hartford Casualty Insurance Company <br />29424 <br />INSURED HUITTZOL <br />INSURER B: Federal Insurance Company <br />20281 <br />Huitt-Zollars, Inc. <br />1717 McKinney Ave., Ste. 1400 <br />INSURER c: Hartford Fire Insurance Company <br />30104 <br />INSURER D: <br />Dallas TX 75202-1236 <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 899364110 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 />MD <br />POLICYNUMBER <br />EFF <br />MMIDDIYYYY <br />EXP <br />POLICYPOLICY <br />MMIDDYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />46UUNOL5275 <br />9/1/2020 <br />9/1/2021 <br />EACH OCCURRENCE <br />$1000000 <br />Cl-AIMS-MADE 1XI OCCUR <br />DAMAGE PREMISES Eccu a orrDence <br />$300000 <br />MED EXP (Any one person) <br />$10000 <br />PERSONAL&ADV INJURY <br />$1000000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$2000000 <br />POLICY PEP LOC <br />PRODUCTS-COMP/OP AGO <br />$2000000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />46UENOL5276 <br />9/1/2020 <br />9/1/2021 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1000000 <br />X <br />BODI LY I NJURY(Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTO$ONLY AUTO$ <br />BODI LY I NJURY(Per accident) <br />$ <br />HIRED NON -OWNED <br />AUTO$ ONLY AUTO$ ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />X <br />$ <br />Coll $1,000 X Comp $1 000 <br />A <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />46XHUOL5274 <br />9/1/2020 <br />9/1/2021 <br />EACH OCCURRENCE <br />$10000000 <br />AGGREGATE <br />$10000000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X RETENTION$inning <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />46WE0L6HIG <br />9/1/2020 <br />9/1/2021 <br />X PER OTH- <br />STATUTE ER <br />ANYPROPRIETORIPARTNERIEXECUTIVE <br />EL EACH ACCIDENT <br />$1000000 <br />OFFICERIMEMBEREXCLUDED9 FT] <br />N/A <br />E. L. DISEASE - EA EMPLOYE <br />$1000000 <br />(Mandatory in NH) <br />If as, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1000000 <br />A <br />Hi red Car Physical Dam.$50,000 <br />46UENOL5276 <br />9/1/2020 <br />9/1/2021 <br />Hired PD Comp/Coll <br />Ded$1,000/$1,000 <br />B <br />Employee Then <br />82241508 <br />9/1/2020 <br />9/1/2021 <br />Employee Then <br />Limit:$1,000,000 <br />A <br />Valuable Papers <br />46UUNOL5275 <br />9/1 /2020 <br />9/1 /2021 <br />Valuable Papers <br />Limit:$25,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />Additional Insured form #HG0001 edition 09/16 applies to the General Liability policy. <br />Waiver of subrogation form #HG0001 edition 09/16 applies to the General Liability policy. <br />Primary & Non -Contributory General Liability form #HG0001 edition 09/16. <br />Additional Insured form #HA9916 edition 03/12 applies to the Automobile Liability policy. <br />Waiver of subrogation form #HA9916 edition 03/12 applies to the Automobile Liability policy. <br />Primary & Non -Contributory Auto Liability form #HA9916 edition 03/12. <br />See Attached... <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <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 />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Rifle hlwaganent Didsian <br />ram. <br />REVIEWED &{APPRovED By., <br />olllli111-1� /-z' rb6HlM�e UsRRE/t¢bl. <br />® Risk Management Analyst <br />