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<br />CERTIFICATE OF LIABILITY INSURANCE ` 211912020_
<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 endorsement(s).
<br />Paooucea License IT 0757776 NAMEacr
<br />'Concord, CA - HUB International Insurance Services Inc. PHONE
<br />12300 Clayton Rd. (AC, Im. Ewl: (925) 609.6500 !arc. N„ 1:(925) 609-6550
<br />Concord, CA 94520 ppo Fl ESS
<br />INSURERS) AFFORDING COVERAGE NAICR
<br />INSURERA+ Colony Insurance Company 39993
<br />INSURED
<br />INSURERS: Liberty Mutual Fire Insurance Company 23035
<br />Graffiti Protective Coatings, Inc.
<br />INSURER C'
<br />419 North Larchmont, #264
<br />INSURER D:
<br />Los Angeles, CA 90004
<br />INSURER E
<br />INSURER F
<br />COVERAGES_CERTIFICATE NUMBER: — 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 PER100
<br />INDICATED A1QTSIr7HH7ANDUJn ANY REOUIRENIEN T. TERM OR CONDITION OF ANY CONTRACT (DR OTHER DOCUMENT V,I rH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DCSCRI8EO HEREIN IS SUBJECT TO ALL THE TERA S
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />INSR ADOL EUBR POIIQ EFF POLICY E:XP
<br />,lTR T__
<br />YPE OF INSURANCE INW N'1P.__POLICY NOMBER MtA,DDiT'rYTI MMIOOrA`YYYI LIMITS
<br />A X COMMERCIAL GENERAL UASILITY EAC'IP>'LRREmOES 1,000,000,
<br />C: ,1%1=_NuoE X oC•. Un X PACEP4245050-01 2117f2020 2/17/2021 DA-IAGE TO Ro'rtED 100,0001
<br />PEEM6E51Gi .¢vnnrccl >
<br />X BI1PD Ded: 2,500 alEn E lP am'.,, -awls.,. > 5,000
<br />esurLr�s,¢•e w:uR.. 1,000,000
<br />CEr% ACGREGATELIAIIF APPLIES PER UE\ ^L q,:,JeEi0T2
<br />:.T '.r 2,000,008
<br />Puc, X JPPnIaPerr:: 2,000,000
<br />B
<br />_OTHEIT
<br />AUTOMOBILE LIABILITY
<br />X ,nrc ono
<br />X X AS2291-466837-0I0
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<br />AV rOi OgLv AUTCtS
<br />"RID
<br />A-TIS ONO A.ITOSONL-
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<br />EXCESS LIAR CIAAIS-MAJE
<br />TIED RETENTIONS
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<br />WORMERS COMPENSATION
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<br />AND EMPLOYERS LIABILITY YIN
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<br />X WC2-Z91-466837-020
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<br />DESCRIPTION O PEHAinii :w;r
<br />1,000,000
<br />Eoo ,hcl s
<br />1/1/2020 ,4dIIINIZ1 FCC, 0.11Il: r-;Per S,. S
<br />.10PI lhlonY ,Pcr
<br />PRG�=dT`, OTLIA6F
<br />A-:r 111-1111. EN _E_..
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<br />--1,000,0001
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<br />1 `112020 111/2021
<br />L'_ E CH AO.]IDENT _z
<br />�, 05E+.E-EA EAIPI ','•rr 5
<br />1,000,000
<br />'s L Dlsr-sr -Port V 11MIFS,
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS!LOCATIONS i VEHICLES (ACORD 101. AddifinIPI RamnMs ScrvedWe, may be AU.Pfied If mory spnca Ic rep ... Idl
<br />'Re. Service Contract
<br />jCity of Santa Ana, its officers, agents. employees and representatives, as additional insured as respects to General Liability per attached forms
<br />EPACE101.0814 & EPACE1 00-08 14. and coverage applies on a Primary & Non -Contributory basis per EPACE107-0714; and additional insured in respects to
<br />:Auto Liability per AC8467 0415. Waiver of Subrogation applies to Auto Liability per AC8407 0713. pg. 10 of 11, XXIII, and Workers Compensation per
<br />WC040306 (4-84). As required by written contract.
<br />'30-Day Notice of Cancellation for General Liability will be provided in accordance with attached form EPACE106-0714.
<br />CERTIFICATE HOLDER _ By RISk.MANAGE D(VISIONCANCELLATION
<br />O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City OI SantAna THE EXPIRATION DATE THEREOF. NOTICE WILL RE DELIVERED IN
<br />Y a ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th Flo - --- --
<br />Santa Ana. CA 92702 JOI AUTHORIZED REPRESENTATIVE
<br />• �Y�PL:A c:Z•:v.4yt
<br />ACORD 25 (2016103) Oc 1988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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