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ACORO" CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MNIDDIYYYn <br />4/1612020 <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(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 endorsements . <br />PRODUCER <br />Brown & Brown Insurance of AZ, Inc <br />2800 North Central Avenue, Suite 1100 <br />Phoenix AZ 85004 <br />CONTACT <br />NAME: Made Puetz, CISR <br />I N , No F.Ik 602-664-7043 aC No,:602-287$743 <br />1ODAR'LEss m e bb hoeniX.wm <br />INSURER(S) AFFORDING COVERAGE <br />HAIG# <br />INSURER A: Travelers Insurance Company of Canada <br />INSURED AVOLSOF-01 <br />Avolv4835 Software Road, Ste <br />4835 East Cactus Road, Ste. 420.. <br />INSURER B: Travelers Property Casualty Co of AM <br />25674 <br />INSURER C: Travelers Indemnity Company <br />25658 <br />INSURER D: <br />Scottsdale AZ 85254 <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 172155965 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 />INS0. <br />TYPE OF INSURANCE <br />ADD <br />9UBR <br />POLICY NUMBER <br />POLICY EFF <br />M <br />POLICY UPT <br />LIMITS <br />B <br />A <br />X <br />COMMERCIALGENERALUABILRY <br />CLAIMS4A9DE aOCCUR <br />Y <br />Y <br />ZLP4IM23114 <br />UXTRV30797 <br />lIV2020 <br />11212020 <br />11=021 <br />1r2R021 <br />EACH OCCURRENCE <br />51,000,000 V <br />PREMISES Ea.. n <br />$1,000,000 <br />MED UP(My one Person) <br />$10,000 <br />PERSONAL S ADV INJURY <br />5IOWD00 <br />AGGREGATE LIMIT APPLIES PER <br />POLICY a JECOT 1:1LOG <br />GENERAL AGGREGATE <br />$2,000,000 <br />GEN'L <br />PRODUCTS -COMPATP AGO <br />S2.000,000 <br />X <br />OTHER: Foreign Late <br />q <br />$2,000,000 <br />C <br />A <br />AUTOMOOMELIABILIY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Y <br />Y <br />BASJ542207 <br />UXTRVM797 <br />1IM020 <br />11=020 <br />'/ <br />1/2/2021 <br />1/2/2021� <br />COMBINED SINGLELIMIT <br />g1000000 <br />BODILY INJURY (Per Person) <br />g <br />BODILY INJURY P <br />(Par a¢ em) <br />$ <br />X <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />p r qn <br />$ <br />X <br />F X HNOA <br />Any One Accitlenl <br />S2,000,000 <br />B <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />Y <br />Y <br />CUP31-995642 <br />1/2/2020 <br />1=021 <br />EACH OCCURRENCE <br />$4.000,000 <br />I <br />ICLaJMS-MADE <br />AGGREGATE <br />$4,000.000 <br />EXCESS LIAa <br />OED <br />I X I RETENTION $ in,, <br />$ <br />C <br />WORK ERSCOMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />OFFICEIalEMBANYPROPRIETOWPARTNEREEXELUTNE N <br />DPPILERMEMNEREXLLODED? <br />NIA <br />Y <br />UBBJ755123 <br />102020 <br />/ <br />1/212021 <br />/ <br />X STRT ERµ <br />E.L. EACH ACCIDENT <br />$1.000,000 <br />EL DISEASE -EA EMPLOYEE <br />51.000,000 <br />(M es, dom y In NH) <br />n pas, describe under <br />DESCRIPTION OF OPERATIONSC <br />E.L. DISEASE -POLICY LIMB <br />$1,000000 <br />B <br />A <br />PyM1SWaW a Cyb6f UaNllry <br />FaalOn Prd UaNldy <br />N <br />N <br />N <br />N <br />ZPL21POS221 <br />UXTRV30797 <br />1W2020 <br />1/2/2020 <br />1/2/2021 <br />1/2/202} <br />✓/ <br />Ag= <br />Refendon <br />Ap9repaltAaduNnb <br />S,0000 <br />10,000 <br />5,000.000/10,00) <br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES IACORD 101. AddlUonal Remarks Schedule, may be stlached if mom space Is required) <br />Blanket Additional Insured applies where required by written Contract to General Liability per attached form CG D4 17 02 191ncluding Blanket Waiver of <br />Subrogation. Blanket Primary 8 Non -Contributory applies to General Liabilitlyy per attached forth CG T1 00 02 19. Blanket Additional Insured applies to Auto <br />Liability per attached forth CA T4 37 02 15. Blanket Automobil ability WN'r of Subrogation applies per form CA T3 40 2015. Excess Liability is Following <br />Form for both General Liability and Automobile Liability. <br />Blanket Waiver of Subrogation applies to Workers' Compensation per attached form WC000313 (00)-01. Privacy Liability is added to the Network and <br />Information Security Coverage Form SPR Tt 03 01 17. / <br />See Attached... <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />2010 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />L ACCORDANCE WITH THE POLICY PROVISIONS. <br />ANGIE ACEVE(IO AUTHORIZED REPRE <br />`I A O <br />ACORD CORPORATION. All riahts <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />