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CERTIFICATE 4F LIABILITY INSURANCE DATE(MMIDDNYYY)
<br />05/20/2020
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />CERTIFICATE
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE RBY (S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED
<br />provisions or be endorsed,
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of thepolicy, certain policies may require an endorsement, A
<br />statement on
<br />this certificate does not confer rights to the certificate holder In lieu of such endorsement a.
<br />PRODUCER
<br />PAYCHEX INSURANCE AGENCY, INC.
<br />NA D peychex Insurance Agency Inc
<br />PRONE an.eeesssD FAX
<br />AID 505-3894425
<br />E-MAIL
<br />150 SAWGRASS DRIVE
<br />ROCHESTER, NY 14620
<br />cells@paychex.com
<br />A DRESS: -_
<br />INSURER(S)AFFORDINO COVERAGE
<br />NAICO
<br />---
<br />INSURER A : P C In$Ura nCe Company Df 1he HartfOld
<br />INSURED
<br />[clean Commercial Cleaning Services Inc
<br />INSURER B: AmGuard Insurance Company
<br />INSURE Gendnel Insuranra Company LTD
<br />4540 Campus Dr Ste 100
<br />INSURER t
<br />Newport Beach, CA 92660
<br />INSUREREt
<br />INSURER F:
<br />COVERA[9FR r�eorrc:rnre xrna..�.-n.
<br />__......_... _.,_.....�... REVISION NUMBER:
<br />THIS IS TO. CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED
<br />NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT
<br />WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF_SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY
<br />INSR ADD,. R-- PAID CLA(MS,
<br />T TYPE OF INSURANCE POLICyyE�FF POLICY EXP �—
<br />�'T -�-
<br />,,, POLIOYNUMSER- MMIOD/Y,YY.YL MDD LIMITS
<br />X COMMERCIALGENBRAL LIABILITY ���•----^
<br />EACH OCCURRENCE $ i,00O,000
<br />CLAIMS -MADE OCCUR ISESEREN ur one $ 1,000,000
<br />C -- - X 76SBWBD9690 MED UPAnyone arson) $ 10,000
<br />., 02/01/2020 02/01/2021 PERSONAL$
<br />ADV INJURY $ 1.000,000
<br />.GENT AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2.000,000
<br />X POLICY ❑ JEG7 El LOC
<br />PRODUCTS-COMP/OPAOO $ 2AOO,ODO
<br />OTHER: $
<br />AUTOMOBILE
<br />LIABILITY
<br />C 91NED SINGLE LIMIT
<br />E ec ___ _
<br />$ 1,0OQ000
<br />B
<br />ANY AUTO
<br />X AUTOSULEO
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY IPeracclden0
<br />AUTOS ONLY
<br />'��� ®���
<br />01/19/2020
<br />01/19/2021
<br />X
<br />AUTOS ONLY X AUOfN056NLb
<br />PeOPERTY DAMAGE
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />EACH OCCURRENCE
<br />AGGREGATE
<br />$
<br />DED RETEMION$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />PER OTH-
<br />X` I
<br />$
<br />A
<br />YIN
<br />OFFICEANYPRNIrMS REXC UDED?ECUTIVE
<br />Y
<br />NIA
<br />76WEGAC6LLN
<br />07114/2020
<br />01/14l2021
<br />STATUE E
<br />EL EACH ACCIDENT$
<br />_
<br />1,000,000
<br />C.L. DISEASG EA EMPLOYEE
<br />—
<br />$ 1,000,000
<br />(Mandatory 1. NEREXCLUDEo?
<br />(Mandatory IU NH)
<br />If Yyees describe under
<br />OESGI IPTION OF OPERATIONS below
<br />EL.DISEASE-POLICY LIMIT
<br />S 1.000,000
<br />DESCRIPTION OF OPERATIONS; LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may m a,toolu d if more space Is required)
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this
<br />policy pursuant to written contract, agreement, or memorandum of understanding. Such insurance as is
<br />afforded by this policy shall be primary, and and insurance carried by City shall be excess and
<br />noncontributory.
<br />CFRTIFICATF PICA TIPP > --- 8
<br />City of Santa Ana to
<br />Risk Management Division BY
<br />20 Civic Center Plaza, 4th floor
<br />Santa Ana, CA 92701
<br />ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />PIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ANCE WITH THE POLICY PROVISIONS.
<br />rlahts
<br />„o n� WI`I W I1dere UHU logo are registered marks of ACORD
<br />
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