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Francine R. Digitally eignd by Fro dre <br />k. Villareal <br />Villarpal Date: 202e1 17:pe:05 <br />A4 �® CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM DN ) <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Wood Gutmann & Bogart Insurance Brokers <br />License #0679263 <br />CONTACT <br />JINAME Melissa I netts <br />PHONE FAX <br />7145057000 Alc No:714-573-1770 <br />nooaless: mignelis@wgbib.com <br />15901 Red Hill Ave., Suite 100 <br />Tustin CA92780 <br />INSURERS AFFORDING COVERAGE <br />NAIc# <br />INSURERA: Insurance Company of the West <br />27947 <br />INSURED BOWER-2 <br />Bowers Museum of Cultural Art <br />INSURER B: Philadelphia Indemnity <br />18058 <br />2002 North Main Street <br />INSURER(: <br />INSURER 0: <br />Santa Ana CA 92706 <br />NSURERE: <br />NSURER F : <br />COVERAGES CERTIFICATE NUMBER: 1153059392 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 />rypE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MMIOOA'YY1' <br />POLICY EXP <br />MMIODIYYYV <br />LIMITS <br />B <br />GENERAL LIABILITY <br />PHPK2164330 <br />713012020 <br />7130/2021 <br />EACH OCCURRENCE <br />$1,000,W0 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 1XI OCCUR <br />DAMAGETO RENTED <br />PREMISES Ea occurrence <br />$100,000 <br />MED EXP(My one person) <br />$5,000 <br />PERSONAL &ADV INJURY <br />51,000,000 <br />GENERAL AGGREGATE <br />$5,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG <br />$2,000,W0 <br />X POLICY r PEI LOG <br />$ <br />B <br />AUTOMOBILE <br />LIABILITY <br />PHPK2164330 <br />7I30/2020 <br />7/ 0/2021 <br />COMBINED SINGLE LIMB <br />Ea accident)00 <br />000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />Ix <br />AOS SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY Per accident <br />( 1 <br />$ <br />HIRED AUTOS X NAON-OWNED <br />PROPERTY DAMAGE <br />Per acc dent <br />$ <br />B <br />X <br />UMBRELLA LIAB <br />I X <br />I OCCUR <br />PHUB7331M <br />71302D20 <br />7/302021 <br />EACH OCCURRENCE <br />$5,0W,000 <br />rl <br />AGGREGATE <br />$5,0 o,ow <br />EXCESS LIAB <br />CLAIMS -MADE <br />DEO I X I RETENTION$0 <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />WSD5026850M <br />613012020 <br />6MOI2021 <br />X WC STATU- OTH- <br />ER <br />E.L. EACH ACCIDENT <br />$1OWW .O <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED' ❑ <br />NIA <br />E.L. DISEASE -EA EMPLOYE <br />$1".DW <br />(Mandatory in NH) <br />0 yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$1AW.DOD <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) <br />RE: <br />All Operations usual to the insured's operations subject to the policy terms and conditions. <br />The City of Santa Ana, its officers, employees, agents, and representative are named as additional insured on the General Liability per attached as required by <br />written contract subject to the terms and conditions of the policy. <br />30 Days Notice of Cancellation applies per form to follow. <br />City of Santa Ana <br />Risk Mangement Division <br />20 Civic Center Plaza <br />Santa ana CA 92701 <br />ACORD 25 (2010/05) <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 />ACORD CI <br />The ACORD name and logo are registered marks of ACORD <br />Rick Management Division <br />REVIEWED & APPROVED BY: <br />Risk Management Analyst <br />