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Francine R. Villareal ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDNYYY) `� 8/28/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Patriot Risk & Insurance Services 2415 Campus Drive, Suite #200 Irvine, CA 92612 ONTACT CNAME PHONE 949 486-7900 ac No: EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICM INSURERA: National Fire Insurance Co of Hartford 20478 wwmpatrisk.com OK07568 INSURED Caribou10N. IndusBroad IncSt. 1103 N. Broadwayy St. INSURERB: Continental Insurance Company 35289 INSURERC: American Fire and CasualtyCompany 24066 INsuRER D : Insurance Com an of the West 27847 Santa Ana CA 92701 g NSURER E INSURER F : COVERAGES CERTIFICATE NHMRFR- 979000IQ RFVISInM MIIMo=0- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR POUCYNUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YVYYI LIMITS A �/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 6072075734 6/14/2020 6/14/2021 EACHOCCURRENCE $1000000 PREMISES (Ea Eorcurrence $100000 MED EXP (Any one person) $ 5 000 PERSONAL &ADV INJURY $1000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYEJJEC- �LOC CT GENERALAGGREGATE $2,000,000 PRODUCTS -COMPIOP AGG $2000000 $ OTHER: A AUTOMOBILE LIABILITY 6072076219 6/14/2020 6/14/2021 OMBI ED SINGLE LIMIT $1000000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURYPer accident) ( ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ B UMBRELLALIAB ,/ OCCUR 6072346405 6/14/2020 6/14/2021 EACH OCCURRENCE $25000000 I/ AGGREGATE $25 000 000 EXCESS LII B CLAIMS -MADE DED RETENTIONSNI $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDEDP NIA WSD503304304 3/1/2020 3/1/2021 I �/ STATUTE ER'_ E.L. EACH ACCIDENT $1000000 E.L. DISEASE -EA EMPLOYE $ 1 QOD,000 (Mandatory in NH) If yes, describe under -' E.L. DISEASE- POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS below C Excess Liability ECA58902110 6/14/2020 6/14/2021 Limit $25,000,000 A Short -Term Equipment Leased,Borrow 6072075734 6/14/2020 6/14/2021 $50,000 Limit per Occurrence or Rented from Others 25,000 Limit per Items $1 000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atmched if more space is required) RE: 205 W Civic Center Dr., Santa Ana, CA 92701 Certificate Holder is named as Additional Insured as respects to General Liability per endorsement attached where required by written contract. Certificate of Insurance shall provide (30) day prior written notice of cancellation. City of Santa Ana Risk Management Division 20 Civic Center Plaza 4th Floor Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE L• ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 57299819 120/21 GL,Auto,XS, IM,WC I Stephanie Kunce 19/2B/2020 7:59:21 AM (PDT) I Page 1 of 14 WdelltnnRganad Divlebn REVIEWED & APP=r. ftlsk ManagemnntAnlysl