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rranane K. Francine R.Villareal <br />Date: 2020.09.02 <br />Villareal <br />10:18:53-07'00' <br />A`O_ CERTIFICATE OF LIABILITY INSURANCE <br />0DATE(MMIDDfY3V2020 YY) <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 />Aon Risk Services Northeast, Inc. <br />New York NY Office <br />One Liberty Plaza <br />Broadway, Suite 3201 <br />CONTACT <br />NAME: <br />IMCNNo. Ertl: (866) 283-7122 FAA (800) 363-0105 <br />E-MAIL <br />ADDRESS: <br />New <br />New York NV 10006 USA <br />INSURER(SI AFFORDING COVERAGE <br />NAICN <br />INSURED <br />dhaLos Angeles SMSA LP <br />VAvenuezon Wireless <br />INSURER A: National Union Fl re Ins CO Of Pittsburgh <br />19445 <br />INSURER B: AIU Insurance Company <br />19399 <br />INsuaea c: American Nome Assurance Co. <br />19380 <br />109 <br />1095 Avenue of the Americas <br />rvew York NY 10036 USA <br />INSURER D: New Hampshire Insurance Company <br />23841 <br />NSURER E: <br />NSURER 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 />INSD <br />WVD <br />POLICY NUMBER <br />MMIpD F <br />POLICY <br />MMIDD NYTI EXP <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />Y <br />GL1728890 <br />EACH OCCURRENCE <br />S2,000,000 <br />CLAIMS -MADE ❑% OCCUR <br />AMA NTED <br />PREMISES Ea omuue,, <br />$2, 000,000 <br />X <br />MED EXP (Any one person) <br />$10, 000 <br />XCU Coverage is Included <br />PERSONAL& ADV INJURY <br />$2,000,000 <br />GEN'LAGGREGATE LIMITAPPUES PER: <br />PRO <br />X POLICY JECT LM <br />GENERALAGGREGATE <br />$5,000,000 <br />PRODUCTS -COMPIOPAGG <br />$S,000,000 <br />OTHER' <br />A <br />AUTO MOBILE LIABILITY <br />CA 1114211 <br />ADS <br />06/30/2020 <br />06/30/2021 <br />COMBINED SINGLE LIMIT <br />Es accident <br />S110001000 <br />BODILY INJURY( Per person) <br />A <br />% ANYAUTO <br />CA 4594299 <br />06/30/2020 <br />06/30/2021 <br />A <br />OWNED SCHEDULED <br />AUTOS <br />nla_a_.. NON -OWNED <br />ONLY AUTOS ONLY <br />MA <br />CA 4594360 <br />VA <br />06/30/2020 <br />O6/30/2021 <br />BODILY INJURY per amidenl) <br />pftOPERTY DAMAGE <br />Per accident) <br />A <br />See Next Page <br />06/30/2020 <br />06/30/2021 <br />UMBRELLAUAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />DED <br />RETENTION <br />B <br />DANY <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY YIN <br />PROPRIETOR I PARTNER I EXECUTIVE <br />OFFICERIMEMBER EXCLUDED?NIA <br />wc045886576 <br />ADS <br />WC045886575 <br />06/30/Z020 <br />06/30/2020 <br />06/30/2021 <br />O6/30/2021 <br />X <br />PERSTANTE <br />DTH- <br />R <br />E.L. EACH ACCIDENT <br />$1,DO00 <br />B4O <br />(Mandatory in NH) <br />CA <br />E.L. DISEASEEAEMPLOYEE <br />$1,()00,000 <br />E.L. DISEASE -POLICY UMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />ICI <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Add@ional Remarks Schedule, may be attached if 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 policy. The General Liability <br />policy shall apply as Primary and Non -Contributory insurance to each Additional Insured listed herein. Where permitted by lawβ€ž <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 />`e <br />c <br />13 <br />W <br />13 <br />0 <br />S <br />so <br />m <br />m <br />ou <br />0 <br />h <br />CERTIFICATE HOLDER CANCELLATION ='111 <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 />.'m,.y Rai Maragemlt Division <br />©1988-2015 ACORD CO <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Rrsk MarxTgencn[Malysi <br />