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CERTIFICATE OF LIABILITY INSURANCE <br />DATE a"WoonTYYY) <br />03110/2020 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does <br />not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT NAME: <br />NABAVIAN INSURANCE AGENCY INC <br />PHONE (949) 428-3321 <br />INC, No, Ear; <br />FA% (949) 030-0274 <br />(A)C, No): <br />72186791 <br />2915 RED HILL AVE STE B201 D <br />E-MAILADDREss: <br />COSTA MESA CA92626 <br />INSURER(S) AFFORDING COVERAGE NAIC9 <br />INSURER A: Sentinel Insurance Company Ltd. <br />11000 <br />INSURED <br />INSURER 8: <br />NOGALIS, INC <br />INSURER C: <br />4590 MACARTHUR BLVD STE 500 <br />INsuRER D: <br />NEWPORT BEACH CA 92660-2028 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: DFVI41r1M MIIMDDD• <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.NOTNTHSTANDING 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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />ADOL <br />SUER <br />POLICY NUMBER <br />POLICYEFF <br />POLICY E%P <br />MI <br />LIMITSMMIDD <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE�OCCUP <br />General Liability <br />ly <br />EACH OCCURRENCE <br />$2,000,000 <br />X <br />DAMAGE TO RENTED <br />PREMISES Ea .Doan <br />$1,000,000 <br />MED EXP (Any one Person) <br />$10,000 <br />A <br />X <br />72 SBA IB1832 <br />04/0V2020 <br />:11 }4 20$1" <br />PERSONALSAOV INJURY <br />$2,000,000 <br />GEN'L AGGREGATE UMIT APPLIES PER <br />GENERAL AGGREGATE <br />$4,000,000 <br />POLICY PRO- 0 LOC <br />JECT <br />PRODUCTS <br />$4,000,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea ac 'den <br />$2,000,000 <br />BODILY INJURY (Parperson) <br />ANY AUTO <br />A <br />ALL SCHEDULED <br />AUTOS AUTOS <br />72 SBA IBI832 <br />04/01/2020 <br />D4/01/2021 <br />BODILY INJURY (Per aodden0 <br />X <br />HIRED NON -OWNED <br />AUTOS X AUTOS <br />PROPERTY DAMAGE <br />(Pare ent) <br />UMBRELLA LIAR <br />X <br />OCCUR <br />EACHOCCURRENCE <br />$1,000,000 <br />A <br />E %CE33 LIAR <br />CLAIMS.MADE <br />72 SBA IB1832 <br />04/0112020 <br />04/0112021 <br />AGGREGATE <br />$1,000000 <br />EO <br />X IRETEWION$ 10,000 <br />WORKERS COMPENSATION <br />PER <br />OTH- <br />AND EMPLOYERS• UAOUITY <br />STATUTE <br />ELL. EACH ACCIDENT <br />ANY YIN <br />PROPRIETORIPARTNER/EXECUTIVE <br />OFFICER&IEMBER EXCLUDED? <br />WA <br />EL DISEASE -EA EMPLOYEE <br />(Mandatory In NH) <br />If yes, describe under <br />E.L DISEASE -POLICY LIMIT <br />DESCRIPTION OF OPERATIONS below <br />A <br />FAILSAFE TECHNOLOGY E OR <br />p <br />72 SBA IB1832 <br />04/01/2020 <br />0410112021 <br />Each Glitch <br />Aggregate <br />$1,000,000 <br />$1,000.000 <br />OESCRIPnON OF OPERATONS/LOCA77ONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mcm.pace is required) <br />Those usual to the Insured's Operations. City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured and <br />Coverage is primary and noncontributory, per the Business Liability Coverage Form SS0008, attached to this policy. Notice of Cancellation will be <br />provided in accordance with Form SS1223, attached to this policy. .a <br />[ddaI1;1[0-\Y;1:Ill] 1151=1 N_17[ai:�N _ • . <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />Risk Management Division <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />20 CIVIC CENTER PLZ FL 4 <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORUED REPRESENTATIVE <br />SANTA ANA CA 92701-4058 --------._,,. <br />KtY¢r <br />ACORD 25 (261610j' RiSk MANAf{EMENT DIVISION <br />RD name and logo are registered marks of ACORDORPORATION. All rights reserved. <br />Ar a2a - <br />