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<br />AC6RhP CERTIFICATE OF LIABILITNrINA WRICE Angie
<br />cW9022
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CO
<br />NOT F OR ATIVELY ICIES
<br />BELOW. THIS CERTIFICATE CERT FIICATEOES
<br />OFATIVELY
<br />INSURANCE DOES NOT CONSTITUTE TUTEXA CONTRACT BETWEEN TF;F ISSUING�I L S �al1TI'I0R ZEID
<br />j
<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 />Willis Towers Watson Northeast, Inc.
<br />c/o 26 Century Blvd
<br />P.O. Box 305191
<br />CONTACT Willis Towers Watson Certificate Center
<br />NAME:
<br />PHONE 1-877-945-7378 F' 1-888-467-2378
<br />A/C No Ext : A/C, No :
<br />E-MAIL
<br />ADDRESS: certificates@willis.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />Nashville, TN 372305191 USA
<br />INSURERA: Great Northern Insurance Company
<br />20303
<br />INSURED
<br />CivicPlus, LLC and its direct and indirect subsidiaries
<br />212 West Main St Suite 500
<br />INSURER B: Federal Insurance Company
<br />20281
<br />INSURERC: Endurance American Specialty Insurance Com
<br />41718
<br />INSURER D
<br />Durham, NC 27701
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: W25464256 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 />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />x
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE � OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 2,000,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />A
<br />Y
<br />36025312
<br />05/17/2022
<br />05/17/2023
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />POLICY PRO-
<br />JECT LOC
<br />x
<br />PRODUCTS - COMP/OPAGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINEDSINGLELIMIT
<br />Ea accident
<br />$ 1,000,000
<br />x
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />B
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />7358-87-92
<br />05/17/2022
<br />05/17/2023
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />B
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />x
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />7989-49-14
<br />05/17/2022
<br />05/17/2023
<br />DED x RETENTION $ 0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICE R/M EMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N/A
<br />(23) 7174-92-49
<br />05/17/2022
<br />05/17/2023
<br />x PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />C
<br />Technology Errors and Omissions
<br />PR030018745600
<br />04/30/2022
<br />04/30/2023
<br />Aggregate/ ded
<br />$5,000,000/$25,00
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />This Voids and Replaces Previously Issued Certificate Dated 05/23/2022 WITH ID: W24809984.
<br />The City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are included
<br />as Additional Insureds as respects to General Liability.
<br />General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be
<br />CERTIFICATE HOLDER CANCELLATION
<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 />City of Santa Ana
<br />AUTHORIZED REPRESENTATIVE
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th Floor �
<br />Santa Ana, CA 92702sN REviEwED & APPROVED BY:
<br />© 1988-2016 ACORD °( e Aeevaa
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD — Risk Management specialist
<br />SR ID: 22865989 BATCH: 2605326
<br />
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