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Francine R. Villareal , il. R CERTIFICATE OF LIABILITY INSURANCE DATE /03/ 020 �/ 11/03/2020 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 Weaver & Associates, Inc. PO Box 1508 CONTACT NAME: PHONE (626) 446-6161 FAX No: (626) 445-3827 E-MAIL ADDRESS Arcadia CA 91077 INSURERS AFFORDING COVERAGE NAIL# INSURERA:-State compensation Ina Fund o 35076 INSURED Choura Events INSURERB:Hi BCOX Insurance Company Inc 10200 INSURER C : INSURER D: 540 Hawaii Ave INSURER E: Torrance CA 90503 INSURER F : COVERAGES CERTIFICATE NUMBER: Cart ID 6483 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. INSR71NSU�NCEIMA. LTRrWPEPOLICYNUMBEft ADDL SUER POLICY EFF MMIDDIYYYY POLICY EXP MWDD(YYYY LIMITS H Y EACH OCCURRENCE $ 1,000,000 IX1R Y Y IIS USN 2731012.20 OS/06/2020 OS/06 /2021 DAMAGE PREMSESOEa °Nc Hence 8 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL&ADV INJURY $ 11000,000 GEN'L AGGREGATE R: GENERAL AGGREGATE $ 2,000,000 X POLICY0 C PRODUCTS-COMPIOPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ccident Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ H X MY AUTO Y Y US DAB 2731180.20 05/06/2020 05/06/2021 OWNED SCHEOULEO AUTOS ONLY AUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESSLIAB CLAIMS�MADE OED RETENTION$ $ A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETDRIPARTNEWEXECUTIVE OFFICERIMEMBEREXCLUDED? NIA Y 9275055-2020 05/06/2020 05/06/2021 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L DISEASE -EA EMPLOYEE $ 1,000,000' (Mandatory In NH) #yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 11000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be allached If more space Is required) The following policy endorsement forma apply on a blanket basis per terse listed on each individual form in favor of the certificate holder AS required by written contract: Additional Insured & Waiver of Subrogation with respects to general liability and auto liability; Waiver of Subrogation with respects to workers' compensation. General and auto liability is primary non-contributory. Certificate holder: City of Santa Ana, officers, agents, employees, and volunteers SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza, AUTHHORRIIZED REPRESENTATIVE Santa Ana CA 92702 I/� -a s�"e(„ � �OM1 a'I:,.k(^ Remewm Ii APPROVBJ BY: 01988-2015 ACORD C ,. F44>.c;n.t P, V:.[ AUd ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Allimew Risk Management Analyst Page 1 of 1