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"v d CERTIFICATE OF LIABILITY INSURANCE <br />°" 42112U20 PYYYY) <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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsements . <br />PRODUCER <br />Wood Gutmann & Bogart Insurance Brokers <br />License 0679263 <br />CONTA T Melissa V nelis <br />MAMEPNONE <br />714Aonelis 9 FAX <br />E#1aIL mi nelis bib.com <br />15901 Red Hill Ave., Suite 100 <br />Tustin CA92780 <br />INSURER(S) AFFORDING COVERAGE <br />NAICS <br />INSURER A: Continental Casualty Co <br />INSURED CLINI-2 <br />Clinical Laboratory of San Bernardino, Inc. <br />Geo-Monitor, Inc. <br />INSURER B: Hartford ACC & Indemnity CO <br />INSURER c: American Cas Co of Reading PA <br />20424 <br />INsuRER D : Continental Insurance Company <br />PO Box 329 <br />San Bernardino CA 92402 <br />INSURER E <br />INSURER F <br />CERTIFICATE <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 />INLTR SR <br />TYPE OF INSURANCE <br />SUER <br />POLICYNUMBER <br />MADOL OLUUY� <br />MMMO Y <br />LIMITS <br />C <br />GENERAL LIABILITY <br />Y <br />B(X`M75 <br />2/12020/ <br />211/Z021. <br />EACH OCCURRENCE <br />3LODD000 <br />X COMMERCIALGENERALLWBILITY <br />✓/ <br />J/ <br />1 <br />S1DD.000 <br />MEO IEXP (Any we <br />510,000 <br />CLAIMS -MADE MOCCUR <br />PERSONAL B ADV INJURY <br />f 1000,000 <br />GENERAL AGGREGATE <br />S2.000.000 <br />GENL AGGREGATE <br />LIMIT APPLIES PER <br />PRODUCTS-COMP/OP AGG <br />$2,000.000 <br />Poucy <br />X PRO- X LOC <br />$ <br />B <br />AUTOMOBILE <br />LIABILITY / <br />72UECHFW15 <br />Vi0oD <br />21Inul <br />COMBINED SINGL LIM <br />X <br />ANY AUTO ,/ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />J <br />✓ <br />BODILY RLURY(Per person) <br />S <br />BODILY INJURY (Per acdtlm0 <br />S <br />"RED AUTOS ANIIT VMEO <br />"RED <br />PROPERTY DAMAGE <br />$ <br />0 <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />CUE6070281162 <br />2I1=0 <br />W=1 <br />EACH OCCURRENCE <br />AGGREGATE <br />LIAB <br />CWMS-MADE <br />DED X RETENTIONS IDOW <br />B <br />YrORKER3 COMPENSATION <br />EMPLOYERS' LIABILITY <br />PROPRIETORIPARTNERIEXECUTNE YINE.L <br />OFFICERMEMBER EXCLUDED' <br />NIA(Mandalay <br />72WECAESFUo <br />2/1/2020 <br />211=?1. <br />/ANY <br />X wC STATU- OT14AND <br />3$5.=.=EXLESB <br />EACH ACCIDENT <br />EL DISEASE-EAEMPLOYE <br />In NH) <br />der <br />Byosde5OlbeaFOEL <br />DESCRIPTION OF OPERATIONS Chow <br />DISEASE -POLICY LIMIT <br />A <br />Envaememal ProfesawrW Lra011 <br />m <br />Cle. Made Cove <br />Dadu be:$100.OW <br />EEH276170520 <br />V1r2020 <br />✓ <br />2/112°Zt <br />/ <br />Par Clam J00°.000 <br />Ag)yaVeie J.W0.000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atmch ACORD 101. AddlUre gnal Remarks Schedule. N moapace Is required) <br />RE: All Operations usual to the Insured's operations subject to the policy terms and conditions <br />Certificate holder is named as additional insured on the General Liability per attached CNA75081XX(1-15) as required by written contract subject to the terms <br />and conditions of the policy. <br />CeNficate of Insurance shall provide thirty (30) day prior written notice of cancellation per form to follow from carrier. <br />Primary and Nan -Contributory applies on the General Liability per attached <br />By Risk MAI <br />City of Santa Ana V Risk Management Division APR <br />20 Civic Center Plaza, 4th Floor / <br />Santa Ana CA 92701 ---�� <br />ACEVEdo <br />1$HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Y}IE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />(D1988-2010 ACORD <br />I <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />