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ROMANS <br />CERTIFICATE OF LIABILITY INSURANCE I °AM;M"' <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 />PRODUCER <br />BmkkeSchafnitz Ins. Brokers <br />License #OK07568 <br />28202 Cabot Road, Suite 600 <br />Laguna Niguel, CA 92677-1251 <br />WOUMD Catholic Chartles of Orange S R <br />County <br />1820 E 16th Street INSURER C: <br />Santa Ana, CA 92701 INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER- RFVISIONNIIMRFR- <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 />HOURTYPE <br />OF INSURANCE <br />AODL <br />SUB <br />POLICY NUMBER <br />POLICY EFF <br />POLICY E%P lifflinArf"IMLMRB <br />COMMERCIAL GENERAL LNSILITY <br />CLAIMS -MADE ❑OCCUR <br />9AcH QC9J8fUENC9 <br />DAMAGE TO RENTED <br />MED FXP An one om" <br />GENL <br />PERSONAL B ADV INJURY <br />AGGRE TE LIIMII.T. AP 1 SPERI <br />POLICY�JpwT LOCPRODUCTS-COMPIOP <br />OTHER <br />GENERAL AGGREGATE <br />G <br />S <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED scHEouLEO <br />AUTOS ONLY AVTµNO.OpSW�/,�1y pp <br />HAU <br />U S.ONLY AUTOS ONLY <br />COMBINED SINGLE LIMIT <br />BODILY INJURY Per evon <br />BODILY INJURY cci <br />�PERe I AMAGE <br />UMBRELLA LAB <br />E <br />EACH OCCURRENCE <br />AGGREGATE <br />DED RETENTIONS <br />A WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANYPROPRIETORPARTNEFUEXECUTIVE <br />OFFICERIMEEMSV EXCLUDED? <br />(alleac orylnN I <br />OI SRILtleaTIXIOe Oder PETONS belowPN <br />NIA <br />Y <br />10005295 <br />07/0112020 <br />0710112021 <br />X PER OTM- <br />El ACCIDENT <br />6 1,000,000 <br />E.L. DISEASE-EAE PLOY <br />1.000,000 <br />1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If mom apace la required) <br />Waiver of subrogation WC0403060484 is extended on behalf of City of Santa <br />Ana, its officers, employees, agents and representatives <br />REVIEWED & APPROVED <br />rERTIFICATE HOLDER CANCELLATION <br />JU+ <br />bAAN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City Of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Divis <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />AN(. <br />R. VILLAREA <br />AUTHOROED REPRESENTATIVE <br />ACORD 25 (2016/03) ©1988.2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />