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Francine R. mwM.a•.a Mraae.a. Villareal ACbR o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODNYYY) 11/13/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ')NLY 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(ies) 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 endomement(s). PRODUCER CONTACT Nicole Noonan NAME: Welch, Graham & Ogden Ins., Inc. PHONE (703) 530-1300 FJAI 703 530-9994 AooRElet ss: nnoonan@wgoins.com 7723 Ashton Avenue INSURER(S) AFFORDING COVERAGE NAICIf INSURERA: CSU Producer Resources, Inc. 13037 Manassas VA 20109 INSURED INSURER B. Accident Fund General 12304 The Olson Group Ltd INSURER C : 300 N Washington Street mE ER D : Suite 600 INSURER E Alexandria VA 22314 INSURERF: COVERAGES CERTIFICATE NUMBER: 20-21 REVISION NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. NSR LTR TYPE OF INSURANCE AUULSUBK INSO WVD POLICY NUMBER POLICY EFF MMIDDNYYY POLICY E P MMIDDNWY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Me pccuoence $ 100,000 MED EXP (Any oneperson) $ 1,000 PERSONAL B ADV INJURY $ 1,000,000 A Y Y CS00045016 02/13/2020 02/13/2021 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY JECT 0 LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY I NJURY(Par person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS CS00045016 02/13/2020 02/13/2021 BODILY INJURY (Par declined) $ X HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peraccident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE Y CS00068161 02/13/2020 02/13/2021 AGGREGATE $ 5,000,000 CEO RETENTION $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY EMBER/PARTNERIR EXCLUDED? EXECUPVE DNY PRO RIETO (Mandatory in NH) NIA Y WCV6089388 03/14/2020 03/14/202, X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRI PTION OF OPERATIONS below E.L. DISEASE - POLICY Li MIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, its officers, employees, agents, and representatives are named as Additional Insured as required by written contract, subject to policy forms and Conditions. Waiver of subrogation applies. 30 day notice of cancellation applies, except for non-payment. City of Santa Ana 20 Civic Center Plaza 4th Floor Santa Ana CA 92710 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 REPRESENTATIVE 17, 4 / ©1988-2015 ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ��y- � RWeManagenlatt Divislort REVIEWED&pAPPROV®BY: Risk Management Analyst OF