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Franc!ne R. V!IIarea I S(1-i <br />tyF <br />ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDIYVVV) <br />09/04/2020 <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 />CONTACT Cathy Service Van Wyke-Stahl <br />JNAME <br />Sargeant Insurance Agency, LLC. <br />AICNIdo E.t: (818) 561-2600 AIc No): (818) 436-5988 <br />7740 Painter Avenue #210 <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />Ni <br />INSURERA: Liberty Mutual Insurance <br />24082 <br />Whittier CA 90602 <br />INSURED <br />INSURERS: The Hartford <br />29424 <br />INSURERC: Indian Harbor Insurance Co <br />36940 <br />INSURERD: <br />BARTEL ASSOCIATES, LEG <br />INSURER E: <br />411 BOREL AVE STE 620 <br />1 INSURERF: <br />SAN MATEO CA 94402-3525 <br />COVERAGES CERTIFICATE NUMBER: 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. NOTNITHSTAN DING 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 />TR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICVNUMBER <br />POLICY EFF <br />MMIDDIYVVV <br />POLICY EXP <br />MMIDDIYVVV <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 2,000,000.00 <br />CLAIMS -MADE X OCCUR <br />PREMISES Ea occurrence <br />$ 2,000,000.00 <br />SEE FAR (Anyone person) <br />$ 15,000.00 <br />PERSONAL &ADV INJURY <br />$ 2,000,000.00 <br />A <br />Y <br />N <br />BKS (21) 57 29 73 74 <br />09/01/2020 <br />09/01/2021 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE <br />$ 4,000,000.00 <br />POLICY PROJECT [::] LOC <br />X <br />PRODUCTS - COMP/OPAGO <br />$ 4,000,000.00 <br />$ <br />OTHER <br />AUTOMOBILE LIABILITY <br />COMBI dent SINGLE LIMIT <br />Ea acciden <br />$ 1,000,000.00 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />A <br />owNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BAS 21 57297374 <br />( ) <br />09/01/2020 <br />09/01/2021 <br />BODILY INJURY (Per accident) <br />$ <br />X HIRED IxNON-OVNMED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />(Per accident) <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 />AFFIPROPRIE ER ORdPAR UDED?NER/E ECUTIVE FN <br />(Mandatory in NH) <br />NIA <br />Y <br />72 WECAH2RPZ <br />09/01/2020 <br />09/01/2021 <br />X STER ATUTE EE0 <br />E.L. EACH ACC <br />$ 1,OOQ000.00 <br />ELDISEASE- EAEMPLOYEE <br />$ 1,000,000.00 <br />If yes describe under <br />DESCRIPTION OF OPERATIONS below <br />EL.DISEASE - POLICY LIMIT <br />$ 1,OOQ000.00 <br />a aim <br />, <br />MISC. PROFESSIONAL LIABILITY <br />C <br />MPP001715216 <br />09/01/2020 <br />09/01/2021 <br />(Pal Agg) <br />5,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACO RD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CITY OF SANTA ANA, ITS OFFICERS, OFFICIALS, EMPLOYEES, AND REPRESENTATIVES ARE HEREBY NAMED AS AN ADDITIONAL INSURED BY <br />CONTRACT ON POLICY # BKS (21) 57297374 and BAS (21) 57297374 AS RESPECTS TO OPERATIONS OF THE NAMED INSURED ONLY, SEE CG2010. <br />COVERAGE UNDER POLICY # BKS (21) 57297374 & BAS (21) 57297374 IS PRIMARY AND NON-CONTRIBUTORY ABOVE ANY OTHER INSURANCE <br />THE CERTIFICATE HOLDER(S) MAY CARRY. 30 DAY NOTICE OF CANCELLATION. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Risk Management Division <br />30 CIVIC CENTER PLAZA 4th Floor <br />Santa Ana <br />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 />AUTHORIZED REPRESENTATIVE <br />© 1988-2015 ACORD C <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Rime Mrrnaganent DMi flan <br />REVEWED Is APPROVED BY: <br />Risk Management Analyst <br />