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olgltMy signed by FrancineR <br />Francine R. Villareal Vfltr aI <br />Dale: 2020.12.e9 vRJ04 goes' <br />ACOf2LO® CERTIFICATE OF LIABILITY INSURANCE <br />DATE IMMIDDIYYYY) <br />12/09/2020 <br />THIS CERTIFICATE IS ISSUED AS 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 />CONTACT Mary Pofar <br />NAME: <br />ISU- Dunlap Agency <br />plcNNO Ext: (714)838-3158 A16 No: (714)922-6157 <br />700 West 1st St., Suite 8 <br />�mary@dunlapins.com <br />INSURERS) AFFORDING COVERAGE <br />NAIC N <br />Tustin CA 92780 <br />INSURERA: GrealAmedcan Insurance <br />INSURED <br />INSURERS: Oak River Insurance Co. <br />Heritage Museum of Orange County <br />INSURER C : <br />3101 W. Harvard Street <br />INSURER D : <br />INSURER E : <br />Santa Ana CA 92704 <br />INSURERF: <br />COVERAGES CERTIFICATE NUMBER: CL2062204674 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 CONTRACTOR 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 />INSRR <br />TYPE OF INSURANCE <br />INSD <br />MD <br />POLICY NUMBER <br />POLIO <br />MMIDDS"(11f) <br />POLICY EXP <br />(MM/DD/YYYY <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />tU <br />PREMISIIUKNES EaEocccueence <br />$ 300,000 <br />MED EXP(An one person) <br />$ 20,000 <br />PERSONAL&ADV INJURY <br />$ 1,000,000 <br />A <br />PAC 4296301-05 <br />07/01/2020 <br />07/01/2021 <br />GEN'L AGGREGATE LIMITAPPLIES PER: <br />X POLICY ❑ JECPROT- ❑ <br />LOC <br />GENERALAGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP(OP AGO <br />$ 2,000,000 <br />$ <br />OTHER: <br />LIABILITY <br />COMBINED SING LE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />AOWNED <br />SCHEDULED <br />AUTOS ONLY AUTOS <br />PAC 4296301-05 <br />07/01/2020 <br />07/01/2021 <br />POMOBILE <br />aODILYINJURV Per accldenU <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY HAUTOS ONLY <br />PROPERTY DAMAGE <br />Perawldenl <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />ANDEMPLOYER9'LIABILITY <br />ANYPROPRIMBERIPARTNDED? unvE Y❑ <br />In NH) EXCLUDED? <br />(Mandatory In NH) <br />(Mandatory <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />HEWC116523 <br />07/01/2020 <br />07/01/2021 <br />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 />E.L. DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />A <br />Building <br />PAC 4296301-05 <br />07/01/2020 <br />07/01/2021 <br />Ded: $5,000 <br />$6,365,305 <br />DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES (ACORD 101, Additional Remarks schedule, may bealtached If more space Is required) <br />The City of Santa Ana, It's officers, employees, agents, and representatives are named ad Additional Insured In regards to General Liability per attached <br />CG201511 88 Additional Insured form. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th FI. <br />Santa Ana <br />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 />AUTHORIZED REPRESENTATIVE <br />DeI <br />51988.2015 ACORD <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />.a PJAMmugemmEDbisian <br />��° REVIEWED&ppAPPROVED BY�: <br />SI ,1' � �4h6M.vNE M1v. V4.TAb/daA1. <br />Risk Management Analyst <br />00, <br />