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Digitally signed by Francine R. <br />Francine R. Villareal Villareal <br />Date: 2021.06.15 16:47:15-07'00' <br />ACOCERTIFICATE OF LIABILITY INSURANCE <br />DATE (MY) <br />06/08//2021R" <br />021 <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 Darren Rosenbaum <br />NAME: <br />Taylor & Taylor Ltd. <br />pAHCNr o (818) 981-9700 �C (818) 981-9703 <br />Ext : No): <br />15060 Ventura Boulevard <br />E-MAIL drosenbaum@taylorinsurance.com <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />Suite 201 (License #0731414) <br />Sherman Oaks CA 91403-2436 <br />INSURERA: Federal Insurance Company <br />20281 <br />INSURED <br />INSURER B <br />TV Pro Gear, Inc. <br />INSURER C : <br />1630 South Flower Street <br />INSURER D : <br />INSURER E : <br />Glendale CA 91201 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 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 />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MWDD/YYYY) <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE � OCCUR <br />DAMAGE TO <br />PREM SES (Ea occurrrence)$ <br />1,000,000 <br />_7RETED <br />VIED EXP (Any one person) <br />$ 10,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />79567606 <br />06/10/2021 <br />06/10/2022 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />X POLICY ❑JECT PRO ❑ LOC <br />PRODUCTS-COMP/OPAGG <br />$ Included <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />79567607 <br />06/10/2021 <br />06/10/2022 <br />BODILY INJURY (Per accident) <br />$ <br />X <br />PROPERTYDAMAGE <br />Per accident <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />M <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 2,000,000 <br />A <br />EXCESS LAB <br />CLAIMS -MADE <br />79962588 <br />06/10/2021 <br />06/10/2022 <br />AGGREGATE <br />$ 2,000,000 <br />DED I I RETENTION $ <br />$ <br />AOFFICER/MEMBER <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />EXCLUDED? <br />(Mandatory in NH) <br />NIA <br />79963560 <br />07/22/2021 <br />07/22/2022 <br />/� STATUTE OTH- <br />ER <br />E.L. EACH ACCIDENT <br />1 f000,00O <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />Ifyes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />1,000,000 <br />$ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />City of Santa Ana, officers, agents, employees, and volunteers is included as Additional Insured with respect to claims arising out of the negligence of the <br />Named Insured. Coverage is primary and noncontributory if required by written contract. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana Risk Management Division <br />20 Civic Center Plaza <br />4th Floor <br />Santa Ana <br />CA 92702 <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 />@ 1988-2015 <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />oRaN RAManagementDivisian <br />REVIEWED & APPROVED BY.- <br />o z <br />Risk Management Analyst <br />