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A o® CERTIFICATE OF LIABILITY INSURANCE <br />Francine R. ..m.flrrmomarr,.o�me«. <br />y""I <br />Villareal - <br />FDATE(MM&1DIYYYYI <br />11/11/2020 <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 />(BK) Heffernan Insurance Brokers <br />7702 Meany Ave., Suite 102 <br />Bakersfield CA 93308 <br />CONTACT <br />NAME: Karlss Perry <br />PHONE FAX <br />1 E` 661-489-7380 INC, No:415-778-0301 <br />MAIL <br />ADDRESS: karisspAheffins.com <br />INSURERS) AFFORDING COVERAGE <br />NAIL$ <br />INSURER A: Federal Insurance Company <br />20281 <br />License#: 0564249 <br />INSURED APPLTEC-03 <br />Applied Technology Group Inc <br />4440 Easton Drive <br />INSURERS: Insurance Company of the West <br />27847 <br />INSURER C : Scottsdale Indemnity Company <br />15580 <br />INSURER D: <br />Bakersfield CA 93309 <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 129189129 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 />TR <br />TYPE OF INSURANCE <br />AMSUD <br />NUMBER <br />POLPOLICY <br />MMIDOY� <br />MMIDO/YYXYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />36025222VVCE <br />7/1/2020 <br />7/1/2021 <br />EACH OCCURRENCE <br />$1,000.000 <br />CLAIMS -MADE J OCCUR <br />DAMAGE TO <br />PREMISES YEA occurrence) <br />$1o00,000 <br />MED EJ(P (Any one person) <br />$10,000 <br />PERSONAL &ADV INJURY <br />$1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE <br />$2.000,000 <br />POLICY JECT El LOC <br />PRODUCTS-COMP/OP AGG <br />$2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILELIABILITY <br />2073584639 <br />7/1/2020 <br />7/1/2021 <br />CEOMBINEeDlSINGLE LIMIT <br />$1.000.000 <br />BODILY INJURY (Per person) <br />$ <br />X ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BOOILY INJURY(Peraccident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />X HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />A <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />79894822 <br />7/1/2020 <br />7/1/2021 <br />EACH OCCURRENCE <br />$5.000,000 <br />AGGREGATE <br />$5,000.000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTIONS <br />S <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />AN <br />WPL503611603 <br />3/22/2020 <br />3/22/2021 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />OF ICERIMEMB REXCLU EO?ECUTIVE ❑ <br />N/A <br />(Mandatory in NH) <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />EL.DISEASE - POLICY LIMIT <br />$1,000.000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />C <br />Proffesional Laibility <br />1 <br />EK13354264 <br />11/19/2020 <br />1111112021 <br />Per Claim &Agg <br />$2.000,000 <br />! : <br />— <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Re: As Per Contract or Agreement on File with Insured. The City of Santa Ana its officers, employees, agents, volunteers and representatives are included as <br />an additional insured (primary and non-contributory) on General Liability policy per the attached endorsements, if required. Cancellation notice endorsement for <br />General Liability is attached, if required. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division, 4th Floor <br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />// G—..�' „ WdtMwgrnadDMion <br />�. REvlEwEo fi APPRW®BY: <br />©1988-2015 ACORD C <br />��' <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management Analyst <br />