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CERTIFICATE OF LIH&,M 146M. DN: cn=Sama ha M.
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL AND CONFERS NO RIGHTS UPOII Ty'Ei`i�'fC%YE`HiJL'D'EiY'.'T!H-I�$I�
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND EUfrJMHE COVEF.AG�.� P1RWEa�StL�E3'S
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONS TITU WEEN TH_ ISS&MiMbW6l4(0;0A;Ph0RfhD
<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 />CONTACT
<br />PRODUCER
<br />Bolton & Company NAME: Chau Tran
<br />3475 E. Foothill Blvd., Suite 100 AICNNo Ezt: AIC No:
<br />Pasadena, CA 91107 E-MAIL _ _
<br />www.boltonco.com 0008309 INSURER A: Zurich American Insurance
<br />INSURED INSURER B: Travelers Property Casual
<br />Electro Construction Corp. INSURER C: Tokio Marine Specialty Insu
<br />2225 North Windsor Avenue
<br />Altadena CA 91001 INSURER D:
<br />COVERAGES CERTIFICATE NUMBER: 97R1¢Ra1 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. 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 />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />SUBR
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMIDDYYYY
<br />POLICYEXP
<br />MMIDDYYYY
<br />LIMITS
<br />A
<br />�/
<br />COMMERCIAL GENERAL LIABILITY
<br />�/
<br />�/
<br />GLO 4426516-01
<br />10/1/2020
<br />10/1/2021
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS -MADE OCCUR
<br />-DAMAGE TO -RENTED
<br />PREMISES Ea occurrence)
<br />$100,000
<br />MED EXP(Any one person)
<br />$5,000
<br />PERSONAL&ADV INJURY
<br />$1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />POLICY PEP �LOC
<br />PRODUCTS -COMP(OP AGO
<br />$2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />UABIUnY
<br />✓
<br />BAP 4426517-01
<br />10/1/2020
<br />10/1/2021
<br />COMBINED
<br />INEDISINGLE LIMIT
<br />$1,000,000
<br />✓
<br />BODI LY I NJURY(Per person)
<br />$
<br />ANY AUTO
<br />BODI LY I NJURY(Per accident)
<br />$
<br />OWNED SCHEDULED
<br />AUTO$ONLY AUTO$
<br />HIRED NON -OWNED
<br />AUTO$ ONLY AUTO$ ONLY
<br />PROPERTYDAMAGE
<br />Per accident
<br />$
<br />$
<br />B
<br />�/
<br />UMBRELLA LIAB
<br />�/
<br />OCCUR
<br />ZUP-51 M42882-20-NF
<br />10/1/2020
<br />10/1/2021
<br />EACH OCCURRENCE
<br />$8,000,000
<br />AGGREGATE
<br />$8,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED ✓ RETENTION$10,000
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />OFFIC RANYPROPMEMBEREXCLU ED9 ECUTIVE ]
<br />(Mandatory in NH)
<br />NIA
<br />WC 4426515-01
<br />10/1/2020
<br />10/1/2021
<br />�/ TPERSTATUTE ERH
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,0Q0,Q00
<br />If as, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />C
<br />Professional Liability, SIR $10000
<br />PPK2184904
<br />10/1/2020
<br />10/1/2021
<br />$1,000,000 per incident; $2,000,000 agg
<br />C
<br />Contract Pollution Liab, SIR $10000
<br />PPK2184904
<br />10/1/2020
<br />10/1/2021
<br />$1,000,000 per incident; $2,000,000 agg
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />GL Blanket Additional Insured & Primary and Non Contributory apply per UGL2162ACW0219 attached, only if required by written contract/agreement.
<br />GL and Auto Waivers of Subrogation applies per CG24040509 and UCA424FCW0414 attached. GL, Auto and WC Notice of
<br />Cancellation clauses apply per I1-00171198 & WC040601A attached. Re: ECC #1960, Santa Ana Stadium Retrofit.
<br />Additional Insured(s): City of Santa Ana, Risk Management, it's officers, employees, agents, representatives and volunteers.
<br />CERTIFICATE HOLDER CANCELLATION
<br />ECC #1960
<br />City of Santa Ana
<br />Risk Management Division
<br />Cente 20 Civic r Plaza, 4th floor
<br />Santa Ana, CA 92702
<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 REPRESENTATNE
<br />Chau Train
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />57813841 1 ELECCON-Cl 1 20-21 GL, AU, Umb, WC, Prof & Poll I Angel Jimenez 1 9/26/2020 1D:50:24 AM (PDT) I Page 1 of 11,
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<br />® Risk Management Supervisor
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