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'`ate- ® CERTIFICATE OF LIABILITY INSURANrr- DATE(MM/DOrIYyy) -----�• �•-�� ve/Au/L020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the poiicy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LIC R0'29370 1-925-682-7001 CON ACT Edgewood Partners Insurance Center NAME: Melissa Davie PHONE e a,925-852-0436 FAX Net- 925-852-0486 2300 Contra Costa Blvd E-MAIL Melissa.Davis@e Suite 375 ADORE S: picbrokere. com Pleasant Hill, CA 94523 INSURERS AFFORDING COVERAGE NAICN INSURED INSURERA: REDWOOD FIRE & CAS INS CO 11673 Lutheran Social Services of southern California INSURER B: INSURER C: 435 W. Orange Show Lane, Suite 104 INSURER D: San Bernardino, CA 92408 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 58552375 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE • LISTED BELOW HAVE REVISION NUMBER: INDICATED. NOTWITHSTANDING ANY REQUIREMENT, BEEN TERM OR CONDITION OF ANY ISSUED TO CONTRACT THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN THE POLICIES REDUCED DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, INSR ADDL R BY PAID CLAIMS. L TYPEOFINSURANCE�NSD POLICY NUMBER MMNo/YEFF MMIIO/YYEY P LIMITS COMMERCIAL GENERAL LIABILITY - CLAIMS -MADE 1-1OCCUR EACH OCCURRENCE $ PREMISES lEa occurrence $ MED EXP An one person) Is PERSONAL& ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- ❑ LOC PRODUCTS-COMP/OPAGG $ JECT OTHER: AUTOMOBILELLABIDTY ED SINGLE LI R ANY AUTO BBciden $ BODILY INJURY (Per person) s OWNED C SHEDULED AUTOS ONLY AUTOS HIRED NON-0 WNED BODILY INJURY (Per acdtlant) $ AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Par ac ident E E UMBRELLA LLAB OCCUR EXCESS LIAB CLAIMS -MADE EACHOCCURRENCE $ AGGREGATE $ OED RETENTION A WORKERSCOMPENSATION AND EMPLOYERS'LIABILITY YIN LUKC114928 01/01/20 01/0,121 PER X STATUTE ERH $ ANYPROPRIETORIPARTNERIEXECUnVE E.L. EACH ACCIDENT $ 1r000500 OFFICER/MEMBEREXCLUDED7 (Mandatory in NH) NIA E.L DISEASE -EA EMPLOYEE $ 1,000,000 If yyees, describe under 0ESCRIPNON OFOPERATIONS below E.L. DISEASE -POLICY LIMIT It 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS, / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) Evidence of insurance coverage. REVIEWED & APPROVED By Risk MANAGEMENT DIVISION MAR 02 CERTIFICATE HOLDER ,....,.�.. __._.. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana Public Works Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 /k I USA (`J 01988-2015 ACORD CORPORATION Ali I no AL, V KU name and logo are registered marks of ACORD arunyArgo SASG7T'IG