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A-2015-160-03
<br />Francine R.
<br />Villareal
<br />DESMMAR-01 JBAE
<br />,4�� o CERTIFICATE OF LIABILITY INSURANCE
<br />DAT/13/20IYYYY)
<br />8/13/2020
<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 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 />PRODUCER License # 0757776
<br />CONTNAMACT Juliana B2e, CI$R
<br />HUB International Insurance Services Inc.
<br />4695 MacArthur Court
<br />oo, EMI: (714) 569-2720 3617 IFaAC, No):(714) 784-3999
<br />Suite 600
<br />Newport Beach, CA 92660
<br />aoo'L .juliana.bae hubinternational.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIL#
<br />INSURER A: Sentinel Insurance Company, Ltd.
<br />11000
<br />INSURED
<br />INSURERS, Navigators Specialty Insurance Company
<br />360$6
<br />INSURER C:
<br />Desmond, Marcello & Amster, LLC
<br />6060 Center Drive, Suite #825
<br />Los Angeles, CA 90045
<br />INSURER 0
<br />INSURER E
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMB"R•
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSRft
<br />OF INSURANCE
<br />RDL
<br />ADUBRTYPE
<br />SINVID
<br />POLICY NUMBER
<br />POLICYEFF
<br />MOMADYEXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERAL LIABILITY
<br />CLAIMS -MADE [K OCCUR
<br />X
<br />72SBANM9496
<br />8115/2020
<br />811512021
<br />$ 1,000,000
<br />ENTED nm
<br />PREMno
<br />$ 1,000,000
<br />one ...o
<br />S 10,000
<br />MEACH�CURRENCERENCE
<br />ADVINJURY
<br />$ 1,000,000
<br />GENL
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY JECT LOC
<br />GREGATE
<br />$ 2,000,000
<br />COMP/OPAGG
<br />$ 2,000,000
<br />E BENEFI
<br />$ 2,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMaBINEEDISINGLELIMIT
<br />La
<br />$ 1,000,000
<br />BODILY INJURY Perperson)$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />OWNS ONLY AUTOSpS
<br />ALT 060NLY X AUUTOB ONLB
<br />72SBANM9496
<br />8115/2020
<br />8I1512021
<br />BODILY INJURY Per accident
<br />$
<br />X
<br />IFOPmERTY DAMAGE
<br />$
<br />A
<br />UMBRELLA UAB
<br />EXCESS LIAR
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />72SBANM9496
<br />8/15/2020
<br />8/15I2021
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />DED I X I RETENTION$ 10,000
<br />$
<br />AND EMPLOYWERS COMPENSATION
<br />RS' LIABI ITr YIN
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICERNE BER EXCLUDED?
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONSbel.
<br />NIA
<br />PER TE OTH-
<br />E.L. EACH ACCIDENT
<br />$
<br />E.L. DISEASE - EA EMPLOYE
<br />$
<br />E.L. DISEASE -POLICY LIMIT
<br />$
<br />B
<br />E&O - Claims Made
<br />CE19MPL5952011C
<br />4116 22020
<br />4116/2021
<br />Each Claim
<br />2,000,000
<br />B
<br />Retro Date 411/91
<br />CE19MPL5952011C
<br />4/16/2020
<br />411612021
<br />Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES ((ACORD 101, Additional Remarks Schedule, maybe attached If more space is required)
<br />RE: Contract # A-2011-069, A-2015-157 and A-2615-160. City of Santa Ana, its officers, employees, agents, volunteers & representatives are additional
<br />insureds with respect to general liability per SS0008 04 05, pg 17-20, includes primary/non-contributory. 30 days notice of cancellaion, 10 days for
<br />non-payment of premium, will be delivered per policy provisions.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br />RWeManagementDh6ian
<br />REVIEWED&APPROVED BY:
<br />ACORD 25 (2016/03) ©1988.2015 ACORD C
<br />auk MaDagement Anaryst
<br />The ACORD name and logo are registered marks of ACORD
<br />
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