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A-2017-224-01 <br />'tC4? nrl CERTIFICATE OF <br />LIABILITY INSURANCE <br />09/04/19WY <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, <br />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 pollcy(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 <br />endorsements . <br />PRODUCER <br />PRIME INSURANCE SERVICES, INC. <br />9891 IRVINE CENTER DRIVE #160 <br />IRVINE, CA 92618-4319 <br />OD48024 <br />NAONFAt, kathy <br />PRDNE (949)450-2300 Al NA, (949) 4SO-2311 <br />F.M`a."E at y primepo icy .com <br />INSURER 51 AFFORDING COVERAGE <br />NAICe <br />I IPBA SENTINEL INSURANCE COMPANY <br />11000 <br />INSURED ENGINEERING SOLUTIONS SERVICES <br />INSURERS: KINSALE INSURANCE CO. <br />38920 <br />23232 PERALTA DR., SUITE 112 <br />1111IR111 HARTFORD ACCIDENT & INDEMNITY <br />22357 <br />INSURERD:HISCOX INSURANCE COMPANY, INC <br />10200 <br />LAGUNA HILLS, CA 92653 <br />Agpe F UNITED FINANCIAL CAB CO. <br />11770 <br />(949)637-1405 <br />(949)637-1405 <br />RFPF <br />COVERAGES CERTIFICATE NUMBERREVISION 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 />A <br />TYPEOF INSURANCE <br />Ix9 <br />MNO <br />POLICY NUMBER <br />POLICYE-0 <br />I I <br />DULY -XP <br />M L IYYT'! <br />UMITS <br />X <br />I COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE a]c OCCUR <br />EACH OCCURRENCE <br />3 2 000 000 <br />P E laI E, xcu rant <br />$ 2,000,000 <br />MEG EXP(A one vemon) <br />$ 10,000 <br />PERSONAL B AOV INJURY <br />S 2,000,000 <br />A <br />X <br />�a <br />72SIMT9447 <br />OB/19/3019 <br />B/19/2020 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY [--IPRO-LOG <br />GFNERAL AGGREGATE <br />a 4,000,000 <br />PRODUCTS-COMPIOP AGO <br />S 4,00 000 <br />3 <br />OT14ER <br />AUTOMOBILE <br />LIABILITY <br />L .Itl DSIN Le LIMIT9 <br />BODILY INJURY(Perprnn) <br />S <br />ANYAUTO <br />E <br />OWNED SCHEDULED <br />AUTOS ONLY X AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />X <br />01083720-0 <br />09/D3/201D <br />9/03/2020 <br />R <br />BODILY INJURY(Pw accidern <br />3 <br />x <br />Pft PERTY DAMA e <br />S <br />S <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />S 2,000,000 <br />g <br />$ <br />AGGREGATE <br />B <br />EXCESS LIAB <br />CLAIMSMAOE <br />E <br />0100061807-2 <br />8/29/2019 <br />/29/2020 <br />R TF TI N <br />S <br />C <br />WORKERSCOMPENSATION <br />ANDEMPLOYERS'LIABILITY YIN <br />ANY PROPRIETORIPARTNEWEXECUTIVE <br />OFFICEWMEMBER EXCLUOED? ❑Y <br />(Mandatory In NH) <br />NIA <br />72WECGG6484 <br />8/20/2019 <br />/20/2020 <br />$ I PER OTH- <br />SrATI TE EP. <br />E L EACH ACCIDENT <br />5 1,000,000 <br />EL DISEASE-E4 EMPLOYEE <br />S / / <br />OyYes, de'Xn18under <br />DE' RIPTION DF OPERATIONSM <br />LAFASF- POLICY LIMIT <br />110001000 <br />A <br />BUSMSS PER.%%= PROPERTY <br />72SBAIT9447 <br />p0/19/9019 <br />8/19/2020 <br />B P.P <br />$13,100 <br />DI <br />PROFESSIONAL LIABILITY <br />IMPL2343339.19 <br />08/29/2019 <br />a/29/2020 <br />PLIABILITY <br />$3M/$3M <br />DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101. Addilbnel Remarks SPINedWe, may tb admimd It more spaw is regdmd) <br />City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds <br />with respect to General and auto Liability per attached Endorsements as required by written <br />contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to Workerfs <br />Compensation. 30 day notice of Can RQ.lAl,ataos+[y7&f�PVR@NE9ice for non-payment of premium in <br />accordance with the policy provisiBY (2jMANAGEMENT DIVISION <br />CERTIFICATE EL TI N <br />Additional Insured: ' <br />City of Santa Ana <br />Risk Management DivisioiSAMA THA M. <br />4NY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE POLICY THEREOVI51NOTCE WILL BE DELIVERED IN <br />coaonxc TIONWITDATE <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATIVE C <br />r <br />C 1988.2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />