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Digitally signed by Francine R.
<br />Francine R. ViIlareaI Villareal
<br />Date'. 2020.12L7143069-08'00'
<br />All CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDIVYYY)
<br />11/18/2020
<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.
<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 />Dealey, Renton & Associates
<br />P. O. Box 12675
<br />CA 94604-2675
<br />CONTACT
<br />NAME: Jo Lusk
<br />PHONE FAX
<br />AIc No Each, 510-465-3090 AIc Nog: 510-452-2193
<br />E-MOakland
<br />ADDRESS: certificates@dealeyrenton.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A: Berkley Insurance Company
<br />32603
<br />License#: 0020739
<br />INSURED MIGINCO-01
<br />MIG,Inc.
<br />800 Hearst Ave
<br />INSURER B: Travelers Property Casualty Company of America
<br />25674
<br />INSURER C: The Travelers Indemnity Company of Connecticut
<br />25682
<br />INSURER D
<br />Berkeley CA 94710
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 1097169400 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 />OF INSURANCE
<br />ADDLSUBRTYPE
<br />INSD
<br />WID
<br />POLICYNUMBER
<br />MMIDDPOLICY
<br />IYYYY
<br />MMIDDIIYYYY
<br />LIMITS
<br />B
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />V
<br />y
<br />68011-1899998
<br />8/31/2020
<br />8/31/2021
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CL41M8-M4DE 1XI OCCUR
<br />DAMAGE PREMISES Ea ccu orD grai
<br />$1,000,000
<br />X
<br />MED EXP (Any y one person)
<br />$10,000
<br />Contractual Liab
<br />Included
<br />PERSONAL& ADV INJURY
<br />$1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />POLICY�PET �LOC
<br />PRODUCTS-COMP/OP AGO
<br />$2,000,000
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />F,
<br />y
<br />BA61<931299
<br />8/31/2020
<br />8/31/2021
<br />COMBINEDSINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />X
<br />BODI LV I NJURY(Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODI LY I NJURV(Per accident)
<br />$
<br />X
<br />HIRED N NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />B
<br />X
<br />UMBRELLALIAB
<br />OCCUR
<br />F,
<br />y
<br />CUPOH758762
<br />8/31/2020
<br />8/31/2021
<br />EACH OCCURRENCE
<br />$10,000,000
<br />AGGREGATE
<br />$10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION $n
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />V
<br />UB21553909
<br />8/31/2020
<br />8/31/2021
<br />X ER
<br />STATUTE ERH
<br />ANVPROPRIETOR/PARTNER/EXECUTIVE
<br />EL EACH ACCIDENT
<br />$1,000,000
<br />OFFICER/MEMBEREXCLUDED?
<br />NIA
<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 />I
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />A
<br />Professional Liability
<br />AEC903908702
<br />8/31/2020
<br />8/31/2021
<br />Each Clainn
<br />$3,000,000
<br />Annual Aggregate
<br />$5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additi anal Remarks Sell e, may be attached if more space is result red)
<br />Umbrella Liability policy is a follow -form underlying General Liability/Auto Liability/Employers Liability.
<br />RE: Santa Ana Parks, Facilities, Trails and Open Space Master Plan
<br />City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are named as additional insureds as respects general
<br />and auto liability as required per written contract or agreement. General and Auto Liability are Primary/Non-Contributory per policy form wording.
<br />CERTIFICATE HOLDER CANCELLATION 30 Days Notice of Cancellation
<br />City of Santa Ana, CA
<br />Attn: Silvia Cuevas, Management Analyst
<br />20 Civic Center Plaza, Room 429
<br />Santa Ana CA 92701
<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 />ADTHD REPRESENTATIVE
<br />© 1988-2015 ACORD C
<br />ACORD 25 (2016/03) The. ACORD name and logo are registered marks of ACORD
<br />RISIt T1918.ge nent Diuisinn
<br />(REVIEWED &{APPRO�V�m By.,
<br />o_lllil _11-1PJ-z' rb6HlM�e ram. VaRRE/t¢bl.
<br />® Risk Management Analyst
<br />
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