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WISECAC-Cl
<br />DATE 0112912020 )
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<br />,d►coRO CERTIFICATE OF LIABILITY INSURANCE
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<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: H the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 endorsemen s .
<br />PRODUCER
<br />ACT
<br />Bolton &COmpany
<br />3475 E. Foothill Blvd., Suite 100
<br />Pasadena, CA 91107
<br />PHONE fA%
<br />An: No Eat: 628 799.7000 1 JAIC,No: 626 441.3233
<br />Mae proprasualty@boltonco.com
<br />INSURER(S)AFFORDING COVE N
<br />INSURER :Philadelphia Insurance Company
<br />2 850
<br />INSURED /
<br />INSURER ew York Marine & General InsCo.
<br />16608
<br />INSURE0.
<br />Wiseplace, CA Corp. Wise Silver Center dba: ✓
<br />INSURER u�_
<br />1411 N. Broadway
<br />Santa Ana, CA 92706
<br />IN ERE:
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER REVISION NIIMRFR-
<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 />INSR
<br />TYPE OF INSURANCE
<br />ADOL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICYEXP IaughrrYgri
<br />LIMA
<br />A
<br />%
<br />I COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADE QOCCUR
<br />%
<br />PHPK2080191
<br />01/0112020
<br />✓MEDEXP(Anyorammoml
<br />0110112021
<br />EACH CURRENC
<br />C
<br />1,000,000
<br />OAMAGETOREMED
<br />100,000
<br />$ 5,000
<br />PERSONAL & AOV INURY
<br />3 1,000,000
<br />AGG TE LIMIT S PER
<br />FOLIcr Loc
<br />N RAL A
<br />2,000.00D
<br />S 2.000.00THEIR 0
<br />P AGO
<br />SEXUAL PHYSICAL
<br />110001000
<br />A
<br />AUTOMOBILE
<br />X
<br />LUBILITY
<br />MY AUTO
<br />OWNED SCHEWIFD
<br />�A�U�ppT��O��S ONLY AUTO�S EEpp
<br />ME ONLY % AMOS ONLY
<br />HPK2080191
<br />01/0112020
<br />V
<br />01/0112021
<br />�,,,/
<br />COMBINED SINGLE LIMIT
<br />IFa tl
<br />OILY INJURY P person)
<br />1,000,000
<br />BODILY INURY ent
<br />pR
<br />P� a cMTen, AGE
<br />A
<br />X
<br />UMBRELLA LIAR
<br />EXCESS LIAB
<br />%
<br />OCCUR
<br />CLANsamAM
<br />HUB706685
<br />0110112020
<br />0110112021
<br />EACH OCCURRENCE
<br />1,000,000
<br />AGGREGATE
<br />S
<br />OEO I % I RETENTIONS 10,000
<br />Personal & Adv
<br />1,000,000
<br />B
<br />WORKERS COMPENSATION
<br />AHDEMPLOYERS'LIABILITY NY PROM ETORIPARTNERdXECUnVE
<br />=ENN)REXCUDED? nNIA
<br />NaRA N
<br />C201900006833
<br />081151A2�019
<br />0811\5�/2020
<br />)( PER OTH-
<br />N ACCIDENT
<br />1,000,00 0
<br />EL. DISEASE - EA EMPLOYE
<br />S 1,000,000
<br />Y LIMIT
<br />1,000,000
<br />A
<br />A
<br />ro solo,abili
<br />Crime
<br />HPK1924744
<br />HPKI924744
<br />0110112M
<br />0110112019
<br />✓
<br />OlIP 020
<br />0110112020
<br />✓
<br />Each Occurence
<br />Aggregate
<br />1,000,000
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101. Additional Remarks Schedule, may bemuchod a mom apace Is me ulmd)
<br />GL Additional Insured applies per CG20130413 attached, only If required by wriitay contracdagreement.
<br />Primary and Non -Contributory Wording applies per PIGLOO50712 attached. ✓
<br />Notice of Cancellation applies per IL00171198 attached,
<br />Additional Insured(s): Cify of Santa Ana, its officers, employees, agents, volunteers and representatives.
<br />RE: Operations of the named insured.
<br />By
<br />City of Santa Ana
<br />Rish Management Division
<br />20 Civic Canter Plaza, 4th floor
<br />Santa Ana, CA 92701
<br />MANAGEMENT U ISION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, ACCORDANCE WITH THE POLICY PROVISION8�E WILL BE DELIVERED IN
<br />RIZEO REPRESENTATIVE
<br />ACEVEdO
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<br />I
<br />The ACORD name and logo are registered marks of ACORD
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