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Digitally signed by Tori Pierson
<br />Tori Pierson Date: 2021.09.01 08:30:16 -07'00'
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<br />A� " CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />8/13/2021
<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.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />NAME:
<br />Arthur J. Gallagher & Co. Insurance Brokers of CA.
<br />PHONE FAX
<br />7777 Center Avenue, Suite 400
<br />A/C No Ext : A/C, No): 562-901-4631
<br />E-MHuntington
<br />ADDRESS: CertRequest@ajg.com
<br />Beach CA 92647
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: HanoverAmerican Insurance Company
<br />36064
<br />INSURED
<br />INSURERB: Allmerlca Financial Benefit Insurance Co
<br />41840
<br />Thirkettle Corporation
<br />Aqua -Metric Sales Company
<br />INsuRERc: Hanover Insurance Company
<br />22292
<br />INSURERD: Underwriters at Lloyd's, London
<br />15642
<br />4050 Flat Rock Drive
<br />Riverside CA 92505
<br />INSURERS: Massachusetts Bay Insurance Company
<br />22306
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:694807469 REVISION NUMBER:
<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.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />ZZ3-A664940-06
<br />7/1/2021
<br />7/1/2022
<br />EACH OCCURRENCE
<br />$2,000,000
<br />CLAIMS -MADE OCCUR
<br />DAMAGES(RENTED
<br />PREMISES Ea occurrence)
<br />ccurrence)$
<br />100,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY ❑PRO ❑
<br />JECT LOC
<br />X
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />Emp Ben.
<br />$ 1,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />AW3-A665023-06
<br />7/1/2021
<br />7/1/2022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />C
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />UH3-A664942-06
<br />7/1/2021
<br />7/1/2022
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED X RETENTION $ n
<br />$
<br />E
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />WD3A652982
<br />7/1/2021
<br />7/1/2022
<br />X PER OTH-
<br />STATUTE ER
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />C
<br />Prof Liab/Tech E&O incl Cyber
<br />LH3-A665809-06
<br />7/1/2021
<br />7/1/2022
<br />Each Claim/Aggregate
<br />$2,000,000
<br />D
<br />Pollution Liability
<br />SPECO506
<br />11/24/2020
<br />11/24/2023
<br />Each Occurrance
<br />Aggregate
<br />$1,000,000
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />RE: Advanced Metering Infrastructure (AMI) / Meter Data Management (MDM) system, and related software and services. City of Santa Ana its officers,
<br />employees, agents, volunteers and representatives are included as additional insureds on a primary and non-contributory basis, as respects general liability,
<br />per policy form. Umbrella coverage follows form and extends over the general liability, auto liability and employer's liability. 30 days' notice of cancellation,
<br />except 10 days for non-payment.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Attn: Risk Management Division
<br />20 Civic Center Plaza, 4th Floor, M-28
<br />Santa Ana CA 92702
<br />USA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />-
<br />..� .. FtEmEwEo & APPRovai)
<br />I,., 7Azi Y[f�ttP.br6
<br />@ 1988-2015 ACORD C(
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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