|
Olgaally signed by Francine P.
<br />Francine R,Villareal Villareal
<br />Daremro.oe ss 17a4os 07-W
<br />AC �'® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE/18/2020 YI
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 />Lovitt & ToLl A Marsh and McLennan Agency, LLC
<br />1050 W Washington Street, Suite 233
<br />CONTACT rl
<br />NAME: Betsy Fillicelli
<br />PNDNE . 602-385-7096 aC No:
<br />EUVC.-MAINo,LE,U
<br />ADDRESS: bfillicelli lovitt-touche.com
<br />Tempe AZ 85281
<br />INSURERS AFFORDING COVERAGE
<br />NAICM
<br />INSURERA: Pacific Compensation Insurance Cc
<br />11555
<br />INSURED IECCORP-Cl
<br />IEC Corporation
<br />(se
<br />(see Named Insured List attached)
<br />INSURER B: Argonaut Insurance Company
<br />19801
<br />INSURER c: National Fire Ins Co of Hartford
<br />2 478
<br />INSURERD: Valley Fore Insurance Company
<br />20508
<br />16485 Laguna Canyon Road, #300
<br />Irvine CA 92618
<br />INSURER E: The Continental Insurance Cc
<br />35289
<br />INSURER F: Certain Underwriters at Lloyds, London
<br />COVERAGES CERTIFICATE NUMBER: 737265703 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 />rypE OF
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD/YYYYI
<br />POLICY EXP
<br />IMMIDD)YYYY1
<br />LIMITS
<br />C
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />V
<br />Y
<br />6083274979
<br />7/31/2020
<br />7/31/2021
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMAGETORENTED
<br />PREMISES Ee occurrence
<br />$1,000,000
<br />MED EXP (Any one person)
<br />$15,000
<br />PERSONAL &ADV INJURY
<br />$1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY [X ] jET [X] LOC
<br />GENERALAGGREGATE
<br />$2,000,000
<br />GENT
<br />PRODUCTS - COMPIOP AGG
<br />$2,000,000
<br />$
<br />OTHER:
<br />D
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />6083274982
<br />7/31/2020
<br />7/31/2021
<br />COMBINEDSINGLELIMIT
<br />Eaa aaccident
<br />$1,000,000
<br />X
<br />ANYAUTO
<br />BODILY INJURY (Per person)
<br />$
<br />OWNED SCHEDULED
<br />AUTOS ONLYNAUTOS
<br />BODILY INJURY Per accident
<br />( /
<br />$
<br />X
<br />HIRED NON -OWNED
<br />AUTOS ONLYAUTOS ONLY
<br />PROPERTY DAMAGE$
<br />PeFaccidentX
<br />Deductibles
<br />$1,000
<br />Com &Coll Deductlblas
<br />E
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />6083274996
<br />7/312020
<br />7/31/2021
<br />EACH OCCURRENCE
<br />$15,000,000
<br />AGGREGATE
<br />$15,000,000
<br />X
<br />EXCESSLIAB
<br />CLAIMS -MADE
<br />OED X I RETENTION$
<br />$
<br />A
<br />a
<br />WORNERSCOMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETORIPARTNERIEXECUTIVE ❑
<br />OFFICERIMEMBEREXCLUDED9
<br />NIA
<br />Y
<br />WA-005984-01
<br />WC 920638713484
<br />611/2020
<br />6/1/2020
<br />6/1/2021
<br />ell 2021
<br />X STATUTE EORH
<br />E.L, EACH ACCIDENT
<br />$1,000.000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE POLICY LIMIT
<br />$1,000,000
<br />F
<br />Student Professional Liability
<br />MPL1010320
<br />7/31/2020
<br />713112027
<br />Each Claim
<br />$2,000.000
<br />Aggregate
<br />Deductible
<br />$4,000,000
<br />$15,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />The above -indicated Additional Insured and Waiver of Subrogation (WOS) are provided with respects to General Liability, Automobile Liability, Workers'
<br />Compensation (WOS only) when required in a written and executed contract. Such coverage afforded by these policies General Liability policy for the benefit of
<br />the additional Insured(s) is prima y and any other coverage maintained by such additional insured(s) shall be non-contributory when required in a written and
<br />executed contract. Excess Liability is Following Form.
<br />Supporting endorsements attached include: CNA74879XX 1-15; CNA74857XX 1-15; CNA75014XX 1-15; SCA23500D 10-11; CA044410-13; WC99 03-15:
<br />WC000313 4-84; WC420304B 6-14; WC99 06-01
<br />CITY —its officers, employees, agents, volunteers, and representatives are additional insureds when required by written contract.
<br />City of Santa Ana
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaza
<br />Santa Ana 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 />©1988-2015 ACORD CI
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />"Peet WekTl�mruaFDivlslon
<br />�R*EVIEWED&.ppAP+P,ROVED BY:
<br />Risk ManagementAnalgst
<br />
|