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Digitally signed by Ton Pierson Tori Pierson Date: 2021.07.21 10:40:01 -07'00' / ACOR" CERTIFICATE OF LIABILITY INSURANCE Ill DATE (MM/DD/YYYY) 1 07/12/2021 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 CONTACT Esther Campos NAME: P Rene Williams Agency A CC No Ext : ONE310 317 4433 FAX No): E-MADDRESS: Rwilliams@farmersagent.com 22837 Pacific Coast Hwy Ste D INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: ATAIN SPECIALTY INSURANCE COMPANY 17159 Malibu CA 90265-5841 INSURED INSURERB: MID CENTURY EXCHANGE 21687 INSURERC : MARKEL AMERICAN INSURANCE COMPANY 28932 URM Technologies Inc. DBA United Records Management Inc. INSURER D: ARGONAUT INSURANCE COMPANY 19801 Data Microimaging Company Portashred INSURER E : 4961 Capital Road INSURER F : Shafter CA 93263 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ 5,000 CONTRACTUAL LIABILITY PERSONAL & ADV INJURY $ NOT INCLUDED A Y Y BWPF0002451 02/01/2021 02/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC JECT X PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO B OWNED X SCHEDULED AUTOS ONLY AUTOS Y Y 094299431 02/01/2021 02/01/2022 X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 3,000,000 X AGGREGATE $ 3,000,000 C EXCESS LAB CLAIMS -MADE N N EZXS3042890 02/01/2021 02/01/2022 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ PROFESSIONAL LIABILITY PER CLAIM $1,000,000 D N N 121MPL020104700 06/28/2021 06/28/2022 AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Certificate Holder is a additional insured under this policy. City of Santa Ana its officers, employees, agents, volunteers and representatives 20 Civic Center Plaza 4th Floor Santa Ana, Ca 92701 Cancellation notices are mailed 30 days prior Non pay cancellations mailed 10 days prior CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza 4th Floor Santa Ana Ca 92701 A HORIZ�E�D)REPRESENTATIVE Risk Mmrgmwerimsm /, J, REmEwED & A�� araavm By / (/may v , 70zi Y[f ttPbr6 @ 1988-2015 ACORD C( - "'S"'" nage ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD