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rranone h• Francine R Villareal <br />Date: 2020.09.02 <br />Villareal <br />0:18:53 -07.00� <br />"� o CERTIFICATE OF LIABILITY INSURANCE <br />°"T0613 /2020 "' <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 entlorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsemengs). <br />PRODUCER <br />AOn Risk Services Northeast, Inc. <br />New York NY Office <br />One Liberty Plaza <br />165 Broadway, Suite 3201 <br />New York NY 10006 USA <br />CONTACT <br />NAME: <br />PHONE (g66) 283-7122 FAX <br />(NC. Ne. Exq: A)CNu : (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />INSURERS) AFFORDING COVERAGE <br />NAIC p <br />INSURED <br />LOS Angeles SMSA LP <br />dba verizon wireless <br />INSURERA: NatiDnal Uni On Fire IRS Co of Pittsburgh <br />19445 <br />INSURER 8: AIU Insurance Company <br />19399 <br />1095 Avenue of the Americas <br />New York NY 10036 USA <br />INSURER C: American Home Assurance Co. <br />19380 <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 />ILTR TYPE OF INSURANCE [NBC WVD POLICY NUMBER MMI00 MMIDDM'YY LIMITS <br />A <br />MMERCIAL GENERAL LIABILITY <br />Xcc-C <br />CIAIMS-MADE %OCCUR <br />Y <br />GL <br />EACH OCCURRENCE <br />$2,000,000 <br />D T ERE TE <br />PREMISES Ea occurrence <br />$2, 000, 000 <br />MED EXP (Arty one person) <br />$10,000 <br />U Coverage is Included <br />PERSONALBADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPLIES PER <br />X POLICY ❑PRO-JECT LOC <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS-COMP/OPAGG <br />$5,000,000 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />CA 4594298 <br />ADS <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />Es accident <br />$1,000,000 <br />BODILY INJURY (Par person) <br />A <br />ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY <br />HIREDAUGOS AUTNONOS-OWNED <br />ONLY AUTOS ONLY <br />I <br />MA, <br />CA 4594300 <br />VA <br />06/30/2020 <br />06/30/2021 <br />BODILY INJURY( Per accident, <br />PROPERTY DAMAGE <br />Peractident <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLA UAB <br />H <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAR <br />CLAIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />8 <br />C <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />N/A <br />WC045886576 <br />ADS <br />WC045886575 <br />06/30/2020 <br />06/30/2020 <br />06/30/2021 <br />06/30/2021 <br />X <br />I PER STATUTE OTTry <br />E.L. EACH ACCIDENT <br />$1, 000,000 <br />(Mandatory, in NH) <br />If yes describe antler <br />under <br />CA <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />DESCRIPTION OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requiredl <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 policy. 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 />m <br />M <br />m <br />a <br />h <br />O <br />2 <br />A <br />u <br />Y <br />m <br />U <br />CERTIFICATE HOLDER CANCELLATION ipi <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE t <br />POLICY PROVISIONS.city Of Santa Ana AUTHORIZED REPRESENTATIVE <br />Risk Management DiVision <br />20 Civic Center Plaza, 4th Floor US <br />Santa Ana CA 92701 USA <br />R.*r MAngawd Division <br />9)1988-2016 ACORD COWill <br />.RenEwEo fi llrrR�a�v/m BY: <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD i eiF4Aa.,;e1d P" vit'VAI <br />Risk Management Ana" <br />