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/laas HOUS&HA-07 SGUILLIEN <br />.d►11* o CERTIFICATE OF LIABILITY INSURANCE DAT12112020 <br />7nuzozo <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 riahts to the certificate holder in lieu of such ancinrsemwnNsl. <br />PRODUCER .1.1 atl M vl. o.e 1 <br />Inland Empire-Alliant Insurance Services, Inc. <br />685 Carnegie Dr Ste 265 <br />San Bernardino. CA 92408 <br />INSURED <br />Houston & Harris P C S Inc <br />21831 Barton Road <br />Grand Terrace, CA 92313 <br />886.9861 <br />INSUREMSI AFFORDING COVERAGE <br />886-2013 <br />INSURER c :Travelers Casualty and Surety Company of America r31194 J <br />INSURER_°: Cypress Insurance Company _ _110855 J <br />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 <br />BEEN REDUCED BY PAID CLAIMS._ <br />INTR BR TYPE OF INSURANCE ADOL SUER POLICY NUMBER <br />POLICY EFF POLICY EXP LIMITS <br />A X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ 1,000,000 <br />CLAIMS -MADE X OCCUR )( 1C 103GL0024297-02 <br />6/2412020 6/2412021 DAMAGEPE100,000 <br />EiEMasancesel_�4 <br />-.- _ <br />MED EXP_LAnyon pmggj S 5,000 <br />-- — <br />PERSONAL & AOV INJURY 1 4 1-010,010 <br />GEN-L AGGREGATE LIMIT APPLIES PER: <br />I <br />- 2,000,000 <br />GENERALAGGREGATE <br />p. <br />_ POLICY X JECT LOC <br />PRODUCTS_COMPIOPAGG 5 2,000,000 <br />OTHER. <br />g <br />B AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT 11000,000 <br />X - <br />JEaacoosnlL g <br />- <br />ANY AUTO _ X X ACP3066645740 <br />_. <br />612412020 612412021 'BODILY �wuRY leer oersa�i g <br />OWNED <br />AUTOS LED <br />_ AUTOSONLY SCHEDULE <br />' BODILY INJURY (Per accoenn S <br />x AUTOS ONLY X AUT04 ONLS <br />q p AMAGE <br />jPv <br />. <br />awdeMl $ <br />C UMBRELLA LIAR X OCCUR <br />EACHOCCURRENCE_ g 4,000,000 <br />X EIA EXCESS LR CwMSAWDE ZUP-41N13398-20-NF <br />6124/2020 612412021 'g 4,000,000 <br />- <br />DEG I X I RETENTIONS 10,000 <br />AGGREGATE _ <br />D WORKERS COMPENSATION <br />X IPTATVTE_ <br />AND EMPLOYERS' LIABILITY <br />ERµ _ <br />hELEAcr, <br />ANY PROPRIETOWPARTNER'EXECUTIVE YIN <br />'i. X HOWC013672 <br />91112019 91112020 ACCIDENT g 1,000,000 <br />oFFICEIBM MVREXCLUDED? <br />1MaTIEato y MNH) <br />NIA' <br />M yyees, tl'KUNunder <br />1,000,000 <br />E.L. DISEASE: FAEMPLOYEES_ __ <br />DESCRIFITX]N OF OPERATIDN50eiow <br />EL p14EASE-POLICY LIMIT' 1,000,000 <br />E Prof Liability <br />LHR840572 <br />6124/2020 6124/2021 Agg/Each Claim Limit 2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule. may Oa anachad If more space Is rp,um,c) <br />Job: Agreement A-2017-364 and A-2D77-223. <br />City of Santa Ana is an additional Insured, waiver of subrogation as respects to <br />general liability per endorsements attached; additional Insured, waiver of <br />subrogation as respects to auto liability per endorsement attached; waiver of subrogation <br />as respects to workers compensation per endorsement attached. <br />Cancellation Notice, per attached endorsements. <br />CANCELS AND REPLACES THE CERTIFICATE ISSUED ON 612312020. <br />REVIEWED &APPROWD <br />CERTIFICATE HOLDER 15 ANA EMPNT iViSiOP <br />CANCELLATION <br />Mtr)O <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana LLUULL <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Risk Management Division <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Drive FRA CINE R. VILIAREAL. <br />AUUTTHORIZE. REPRESENTATIVE <br />Santa Ana, CA 92702 <br />,L4�, <br />AL.uKV ZO iZUibaJ3) ©1988.2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />