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rldnUllC n. VIIIIIII, Date: 2021.01.2616:16:15 -0ebP ACORO® CERTIFICATE OF LIABILITY INSURANCE 1/l/2022 DATE(MMmDIYYYY) 1 2/11/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Insurance Brokers, LLC 777 S. Figueroa Street, 52nd Fl. CA License #OF15767 Los Angeles CA 90017 CONTACT NAME: PHONE FAX A/C No ExINC.No: E-MAIL ADDRESS: (213) 689-0065 INSURERS AFFORDING COVERAGE NAIC If INSURER A: Safe National Casualty Corporation 15105 INSURED Mission Linen Supply 1346478 702 E. Montecito St. INSURERS: INSURER C : Santa Barbara CA 93103 INSURER D : NSURER E INSURERF: COVERAGES MISLI06 CERTIFICATE NUMBER: 15085893 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR D POLICY NUMBER POLICY EFF MM/DD/YYYY) POLICY EXP (MMsoDIyyM LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR Y N GL4045506 I/l/2021 1/l/2022 EACH OCCURRENCE $ 2000000 PREMISES Ea oN unence $ 500,000 X MED EXP(My one person) $ Not A licable SIR:$250,000 PERSONAL &ADV INJURY $ 2 000 000 GENT AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2 000 000 $ OTHER: A A AUTOMOBILE LIABILITY ANY AUTO Y N CAS4045508 CAS4056505 l/l/2021 1/I/2021 I/l/2022 l/1/2022 COMBINED SINGLE LIMIT Ea accident) $ 5,000,000 X BODILY INJURY (Per Person) $ XXXX�{XX BODILY INJURY accident) $ XXXXXXX OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accitlent $ XXXX7iXX X Como./Coll. Ded $ 1,000 SIR $250,000 UMBRELLA LIAR OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX EXCESS LV CLAIMSWADE DIED I I RETENTION$ $ XXXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? N/A Y LDS4041104 I/1/2021 I/l/2022 PER OTH- 'Y S7AME ER EL EACH ACCIDENT $ 1000000 E.L DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS helow DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FORTHIS HOLDER, APPLICABLE TOTHE CARRIERS LISTEDAND THE POLICY TERM(S) REFERENCED. Re: Agreement Nos. A-2017-172 and A-2017-290. City of Santa Ana, its officers, employers, agents, and representatives are an Additional Insured to the extent provided by the policy language or endorsement issued or approved by the insurance carrier. Waiver of Subrogation applies per attached endorsement(s) or policy language. Notice of Cancellation applies per the applicable policy language or endorsements. 15085893 City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana CA 92702 ACORD 25 (2016103) See SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR � � RukMwgarlatt Dleiawt °= REVIEVOm& APPRw® Br. ©1as.20t t-ACORD c ct r,o !,�� Fµrc R. Vct6 4"t The ACORD name and logo are registered marks of ACORD '�� ® Risk Management Analyst