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Digitally signed by Francine R.
<br />Francine R. Villareal Villareal
<br />ACORO®
<br />`i CERTIFICATE OF LIABILITY INSURANCE
<br />Dare: 2020.121511 ma a5-0800
<br />DATE(MM/DD/YYYY)
<br />12/8/2020
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT NAME: Matthew Cowan
<br />LIC#0E38105
<br />NCNN. Ext : 1310) 361 -5630 X ]06 (qID No)o (888) 560-8728
<br />ADDRESS: TerridoJuliansummers.com
<br />Julian Summers Insurance
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />5155 W Rosecrans Avenue Suite 205
<br />Hawthorne CA 90250
<br />INSURER A: TRAVELERS INDEMNITY COMPANY OF CT
<br />25682
<br />INSURED
<br />INSURER B: TRAVELERS PROP CASUALTY CO OF AMERICA
<br />25674
<br />INSURER C :
<br />MULTI W SYSTEMS INC
<br />INSURER D:
<br />2615 STROZIER AVE
<br />INSURER E:
<br />INSURER F:
<br />EL MONTE CA 91733
<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 FORTH E 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 />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />MD
<br />POLICY NUMBER
<br />(MM/DD/YYYY)
<br />(MM/DD/YYYY)
<br />LIMITS
<br />x
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS-M4DE OCCUR
<br />ENTEO—
<br />PREMISES(Edoccurrence)
<br />$ 100,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL K ADV INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />630-7J22389A-TCT-20
<br />08/01/2020
<br />08/01/2021
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY y PRO-
<br />F)—JECT LOC
<br />PRODUCTS-COMP/OP AGO
<br />$ 2,000,000
<br />OTHER:
<br />DEDUCTIBLE
<br />$ NONE
<br />AUTOMOBILE
<br />LIABILITY
<br />(Ea accitlent)
<br />$ 1,000,000
<br />BODI LV INJ URV(Per person)
<br />$
<br />ANY AUTO
<br />B
<br />Ix
<br />ALL OSCHEDULED
<br />AUUTOSS AUTOS
<br />Y
<br />BA-3N112945-20-CAG
<br />08/01/2020
<br />08/01/2021
<br />BODILY INJURY (Per accident)
<br />$
<br />HIRED AUTOS NON -OWNED
<br />AUTOS
<br />(Peraccident)
<br />$
<br />COMP/COLL DED
<br />$ 500
<br />UMBRELLA LIAB
<br />x
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />B
<br />x
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />CUP-7229094-20-14 Follows GL
<br />08/01/2020
<br />08/01/2021
<br />AGGREGATE
<br />$ 2,000,000
<br />DED
<br />RETENTION $
<br />$
<br />B
<br />ORKERS COMPENSATION
<br />ND EMPLOYERS' LIABILITY
<br />PROPRIETORIPARTNERiEX
<br />YN/A
<br />DFFICER/B BER EXCLUDED kNYECUTIVE FYI
<br />(Mandatory in NH)
<br />Y
<br />UB7J230124-20-14
<br />08/01/2020
<br />08/01/2021
<br />-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE-EAEMPLOVEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS bebw
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />BUSINESS PERSONAL PROPERTY
<br />630-7J22389A-TCT-20
<br />08/01/2020
<br />08/01/2021
<br />$308,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD iDi, AtltlKional Remarks SLhatlula, may bs alti chatl if more space is mquimd)
<br />RE: Agreement No N-2020-111
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as Additionally Insured on this policy pursuant to written contract, agreement, or
<br />memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and
<br />noncontributory. Waiver of Subrogation applies to Workers' Compensation. CITY WILL BE MAILED 30 DAYS WRITTEN NOTICE OF POLICY
<br />CANCELLATION.
<br />CITY OF SANTA ANA
<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 />RISK MANAGEMENT DIVISION AUTHORIZED REPRESENTATIVE
<br />20 CIVIC CENTER PLAZA, 4th FLOOR sis REA MumigammIDMI ian
<br />SANTA ANA CA 92701 REVIEWED & APPROVED BY:
<br />© 1988-2014 ACORD oS11i1>LC' l_z' FgA4,, t,e P, Vjt44ed
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Z�33EKM Risk Management Analyst
<br />
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