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rrancine K. FrancineR7Vi11areaI <br />Date: 1020.09.02 <br />Villareal <br />10:18:53 -07'00' <br />``� CERTIFICATE OF LIABILITY INSURANCE <br />MM/DN <br />DATE(0MM!2020 I <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Anon Risk Services Northeast, Inc. <br />York NY Office <br />One Liberty Plaza <br />165 Broadway, to 3201 <br />suite <br />CONTACT <br />NAME: <br />PHONew <br />(A/C.NNo.Ext): (866) 283-7122 FAx (800) 363-0105 <br />E-MAIL <br />ADDRESS, <br />New <br />rvew York NY 1000006 USA <br />INSURER(B)AFFOROING COVERAGE <br />NAICR <br />INSURED <br />LOS Angeles SMSA LP <br />dba verizon wireless <br />INSURERA: National Union Fire Ins Co of Pittsburgh <br />19445 <br />INSURER 8: AIU insurance company <br />19399 <br />INSURER C: American Home Assurance Co. <br />19380 <br />1095 Avenue of the Americas <br />New York NY 10036 USA <br />INSURER D: New Hampshire Insurance company <br />23841 <br />INSURER E: <br />INSURER F: <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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE 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. Limits shown are as requested <br />LTR <br />TYPE OF INSURANCE <br />INSO <br />WVD <br />POLICY NUMBER <br />UUNNIDDEF <br />it, <br />MMID xP <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />CIAIM&MADE X❑ OCCUR <br />DAMA ET NTED <br />PREMISES Ea occurrence <br />$2,000,000 <br />X <br />MED UP (Any one person) <br />$10, 000 <br />XCU Coverage is Included <br />PERSONAL &ADV INJURY <br />$2,000,000 <br />GENIAGGREGATE LIMITAPPLIES PER: <br />X JECT LOC <br />[]POLICY PRO- ❑ <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS -COMP/OP AGG <br />$5,000,000 <br />OTHER: <br />A <br />AUTO MOBILE LIABILITY <br />CA 4114211 <br />A05 <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />Ea accide t <br />$1,000,000 <br />BODILY INJURY( Per person) <br />A <br />X ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIREDAUTOe NON -OWNED <br />ONLY AUTOS ONLY <br />MA <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />Per accdent <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CI -AIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />B <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABUTY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBER UCLUOEOa <br />NIA <br />wc045886576 <br />AOS <br />wC045886575 <br />06/30/2020 <br />O6/30/202006/30/2021 <br />06/30/2021 <br />X PERSTATUrE <br />OTH- <br />ER <br />E.L. EAGHACCIDENT <br />$1,000,000 <br />(Mandatory in Ni <br />N yes, describe under <br />CA <br />E. L. DISEASE EA EMPLOYEE <br />$1,000,000 <br />E. L. DISEASE-POLICVLIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 8 more space is required) <br />The above -referenced General Liability policy shall cover the tort liability of the certificate Holder assumed under the <br />underlying agreement between parties for which the certificate has been issued. City of Santa Ana its council members, <br />officers and employees are included as Additional Insured with respect to the General Liability pojicy. The General Liability <br />policy shall apply as Primary and Non -Contributory Insurance to each Additional Insured listed herein. Where permitted by law, <br />the Named Insured parties listed herein waive all rights against city of Santa Ana, its council members, officers and employees <br />listed herein for recovery of damages to the extent these damages are covered by the above -referenced General Liability policy <br />and, as further limited by written contract between the parties. <br />co <br />co <br />ad <br />ce <br />m <br />0 <br />0 <br />ua <br />N <br />0 <br />Z <br />R <br />u <br />C <br />m <br />U <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />city of Santa Ana AUTHORIZED REPRESENTATIVE <br />Risk Management Division <br />20 Civic center Plaza, 4th Floor <br />Santa Ana CA 92701 USA <br />©�198�8."-200115 ACORD <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />.�' wasassss. ionwnn <br />ep -�. Cam- 6pMPRW®8Y: <br />�` r9rcfW-hl Fes, V:Lcl <br />�� Rak Managerrlent Analyst <br />