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Oiahally sk nal H Randne n Francine R. Villareal Wlamal pale:]aecn.10:E4:1] 0@W' ACll - CERTIFICATE OF LIABILITY INSURANCE 411./ DATE (MMIDDNYYY) 10/22,2.2. 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 Arthur J. Gallagher & Co. Insurance Brokers of CA Inc. LIC #0726293 21820 Burbank Blvd. Suite 175 Woodland Hills CA 91367 CONTACT Erika Sokollk NAMEPNONE FAX 818-534-3558 AX No:818-316-0990 AD�RIE .E. Erika Sokolik a' .com INSURERS AFFORDING COVERAGE NAICR INSURER A: West American Insurance Company 44393 INSURED Downey Vendors, Inc. DBA: Premier VendGroup INSURER B: Insurance Company of the West 27847 INSURERC: Travelers Property Casualty Cc of America 25674 INSURER D : 6814 Suva Street Bell Gardens CA 90201 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 896981n60 RPVISIf1N NIIMRPR- 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 7ypE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF IMMIDDIYYYY1 POLICY EXP UAMIDENYYYY1LIMITS A TCOMMERCIALGENERALLIASILITY CLAIMS -MADE � OCCUR Y BKW56585014 4/1/2D20 4/1/2021 EACH OCCURRENCE $1,000,000 DAMAGE(RENTED PREMISESS Ea pccupence) $100,000 MED EXP (Any me person) $10,000 PERSONAL&ADV INJURY $1,000.000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT El LOC OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS-COMP/OP AGG $2,D00,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Par parson) $ (Par BODILY INJURY Per accident) $ PROPERTY DAMAGE Per accident $ C X UMBRELLA IL EXCESS LIAR X OCCUR CLAIMS -MADE ZUP16N7899420NF 4/1/2020 4/1/2021 EACH OCCURRENCE $10,000,000 AGGREGATE $10.000.000 DED I X I RETENTION $ n n,D $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER(EXECUTIVE OFFICERIMEMBEREXCLUDED7 (Mandatory in NH) If yes, describe Order DESCRIPTION OF OPERATIONS Was NIA VWES03733304 7/26/2020 7/26/2021 X I STATUTE ERH E.L. EACH ACCIDENT $1.000,000 E.L. DISEASE -FA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of Santa Ana is named Additional Insured With respects to General Liability coverage per attached form CG 8810 0413. 30 days Notice of Cancellation Applies. City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th floor 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 ye�141 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE .v1s91N..c aV RlekMwgiahadDlAsIm .- REVIEWEDSAPPRW R' r. Risk Management Analyst Y 00,