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A SP CERTIFICATE OF LIABILITY INSURANCE <br />o 2W20 a Y) <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(les) must have ADDITIONAL INSURED provisions or be endorsed, <br />If SUBROGATION IS WANED, 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 endorsements .. <br />PRODUCER <br />Marsh Risk& Insurance SaMrxrs <br />17901 Volt Kaman Avenue, Suite 1100 <br />CONTA T <br />PHONE FAX <br />EMP L1AIC..NAI;....._.._... <br />....................._... <br />ENAIL <br />............................_.........o........._...:-.._ <br />(94913W5600: License k0437153 <br />Irvine, CA 02614 <br />_.__...,..-....N.m._..._.............-...o <br />_.._. <br />Attn: NeWPDdBewh.CedRequest@mamh.ComIF: 212-94BA323 <br />INSUR2;RI61 ARFOROINO COVERAGE <br />INSURER A: Harlan] Fire Insurance Company <br />...._NAIC0 <br />HN2 <br />CNt02106416STND-GAWUP-20- <br />(NSUR£O / <br />Griswold Induslrfes, Cla-Val Com✓pany <br />1701 Placentia Avenue <br />INSURER a : NIA <br />NIA <br />------m--^---�—� <br />INSURER c : Twin City Fire Insurance Company <br />----W-- <br />29450 <br />Costs Mesa, CA 92627A475 <br />............ , <br />INSURER 0: NIA MA <br />-.A <br />NIA <br />INSURER E : NIA <br />NIA <br />INSURER F: <br />CFTiV15S T_rc73A�io{d:iill SIsTAf:2HIM, I&iI472I0111,T,I <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 OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INTR <br />TYPEOPINSURANDE <br />ADOL <br />S BR <br />IAmn <br />POLICY NUMBER <br />OLICY EF <br />M <br />OLICY E%P <br />Y <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />B-MADE El OCCUR. <br />ftf,p�.ZSIR <br />72ECSGA1967 <br />04M 020 <br />f"" <br />04101I2021 <br />EACHOCCURRENCE <br />$ i,000,W0' <br />e N I EO <br />S 300,000 <br />MEb EXP hn ono anon <br />$ <br />PERSONAL B ADV INJURY <br />8 1,000,000 <br />_ <br />GEWL AGGREGATE LIMIT APPLES PER: <br />X POLICY El ,C, f LOC <br />OTHER <br />GENERALAGGREGATE <br />2,W0,000 <br />PRODUCTS•CbMPfOP AGO <br />2,000,000 <br />S <br />A <br />AUTOMOBILE LIAOILr'rY <br />X ANY AUTO <br />AUTOS ONLY AUTOSULEO <br />X HIRED M NON -OWNED <br />ONLYAUTOS ONLY <br />72UENUM3154 <br />041E2020 <br />0410112021 <br />COMBINED SINGLE LIMITMLNMOOU- <br />BODILY INJURY(Porparsen) <br />$ 1000004 <br />$ <br />BODILY INJURY (Pot accWes) <br />$ <br />PR PERTY AMA EAOTCG <br />IP., AsLodwIl <br />S <br />UMBRELLA LIAB <br />EXCESS LAB <br />OCCUR <br />CLAIMS -MADE <br />......m..._.M._..w_.�_...m_ <br />-4� <br />EACH OCCURRENCE <br />$ ^� <br />AGGREGATE <br />S <br />DED <br />I <br />I RETENTION$ <br />A <br />C <br />WORRERSCOMPENSAIDON <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPEIVINE BEEXCLUlbE%ECUIIVE <br />(mandaRIMEMeeREXCLUDEDi <br />(Mantlatoryln NH) <br />Ii yes, describe under <br />DESCRIPTION OF OPERATIONS bat <br />NIA <br />72WN03100 CA) <br />72WEHO3564 (AOS) <br />04,101020 <br />W0112020 <br />04MI12021 <br />SIMI 2i <br />X STATUTE .ORµ <br />EA. EACH ACCIDENT <br />§ iA00 p60 <br />E.L. DISEASE =-FA EMPLOYE <br />$ 1•IX10.000 <br />E.L.DISEASE- POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS ILOCAT'IONS IVEHICLES (1CORO 101, Additional Remarks Sahedufe, maybe aaechad if more space to required] <br />ThCkyol Sanafins, its officers, and representatives am iwludedaseddiWanl Insured(exceplworkers'�MnseUon)whammqufmdbywritlomm�tmt. Thislnsuranrals `� e <br />pdmay and nonmNrloulofy ova sly existing insurance and limited to 0ab0ity Msing out of the operations *(the named Insured suWect to Policy iamb era conditions with respect to General Liability. <br />CERTIFICATF Nr11. nF:R I1hVIFUlC712 1�.'__ CANCPI. I. ATIAM <br />By Risk <br />Cityof Santa Ana <br />MANAICEMENr DiviSiON <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Risk Management Division <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Plazary <br />�tt1 <br />2020 <br />ACCORDANCE WITH THE POLICY PROVISIONS <br />Santa Ana. CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />A NgiE �) <br />of Marsh Risk& Insurance Services <br />t1 f�CEVEdo <br />Pam Paterson^''k, <br />©1056.2016 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010103) The ACORD name and logo are registered marks of ACORD <br />S <br />J <br />