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Digitally signed by Francine R Francine R. Villareal viaanyM Data 2020.08.20 11:40.43 07'00' AC"R& CERTIFICATE OF LIABILITY INSURANCE 11..� DATE(MMIDDIYWY) 1 811212020 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 SIP Insurance Services 750 The City Drive South. Ste 450 Orange, CA 92888 CONTACT SIP Insurance services PHONE 626-214-7919 AIC No ADDRIESS brl itte sl brokers.com INSURER(S) AFFORDING COVERAGE NAICN INSURER A: Travelers Property Casualty Co of America 25674 INSURED Backflow Apparatus & Valve Company DBA BAVCO INSURER B : INSURER C: INSURER D; 20435 S. Susana Road Long Beach CA 90810 INSURERE: NSURERF: 1P1-11A9 V-,1b]"A�10tlarU I a Ltl111 i 0 UI VI I ai:(1.Y:L•L1liBi N d11 L4 b1J III,, 11 LG l ei d r� 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. ILTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMIDOM'YY POLICY E%P MIN ONVYY LIMITS A r/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ✓ 630-8J664090 10/31/2019 10/31/2020 EACHOCCURRENCE $1 OOO OOO DAMAGE TO PREMSES(.Occu once $300,000 MED EXP (Any one person) $5,000 PERSONAL &ADV INJURY $1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ✓�JECOT [::]LOC OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2000000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED HIRED ONLY AUTOS HIRED NON-OWNEDPROPERTY AUTOSAUTOS ONLY ✓ AUTOS ONLY BA-7N173419 10/3112019 10/31/2020 COMBINED SINGLE LIMIT $1 OOO,OOO ✓ BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ ✓ DAMAGE per eccldenl $ A UMBRELLA LIAR EXCESS LIAR �/ OCCUR CLAIMS -MADE CUP-9J209005 10/31/2019 10/31/2020 EACH OCCURRENCE $5000000 AGGREGATE $ 5 000 000 DECO I ✓ RETENTION$0 $ A ANDEMPS COMPENA ILON YIN OFF CERPMEMBEREXCLUDED9 ECUTIVEEl (Mandatory In NH) If yes, tlescrthe under DESCRIPTION OF OPERATIONS below NIA UBOL9415782014G 8/27/2020 8/27/2021 ,/ STATUTE ERH E.L. EACH ACCIDENT $1,000000 E.L. DISEASE- EA EMPLOYEE $1 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (AC ORD 101, Additional Remarks Schedule, maybe attached if more space is rare !red) City of Santa Ana and Its officers, employees, agents, volunteers and representatives are named as additional insureds in respects to the general liability policy only per the attached forms. Primary/non-contributory is included in the general liability policy only per the attached form. 30 days notice of cancellation applies to the certholder in regards to the general liability policy only. City of Santa Ana Risk Management Division 20 Civic Center Plaza 4th FL Santa Ana CA 92702 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 /�6n�! Gary Champlin ©1988-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 56994187 1 19-2D CA, Auto, Vmb, 20 21 WC I Brigitte Leber 1 8/12/2020 2:07:31 PM IPDT) I Page 1 of 11 REVIEWED &APPPR.OVED BY. gg i t R,Will R41f Management Analyst