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Digit Tori Pierson Datea21021.10.2611:16:00e0700' ACOR" CERTIFICATE OF LIABILITY INSURANCE Ill 8/1/2022 DATE(MMIDDIYWY) 10/22/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 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 endorsement(s). PRODUCER Lockton Companies CONT NAMEACT 444 W. 47th Street, Suite 900 City MO 64112-1906 (816) 960-9000 PHONE FAX Ext : A/c No fAIC,Kansas E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: LibeM Insurance CO oration 42404 INSURED WACHTER, INC. 1337719 16001 WEST 99TH STREET INSURER B : Employers Insurance Company of Wausau 21458 INSURER C : Steadfast Insurance Co=any 26387 INSURER D : LENEXA KS 66219 INSURER E : INSURER F : COVERAGES * CERTIFICATE NUMBER: 17963731 REVISION NUMBER: XXXXXXX 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR N N TB7-691-472101-021 S/1/2021 8/1/2022 EACH OCCURRENCE $ 2,000,000 DAEMMAGEISES TOEa REocNTED PRcurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 �X JPRO- POLICY LOC PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER: A AUTOMOBILE LIABILITY N N AS7-691-472101-011 8/t/2021 8/1/2022 COMBINED SINGLE LIMIT Ea accident $ 3,000,000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO BODILY INJURY (Per accident) $ XXXXXXX OWNED SCHEDULED AUTOS ONLY AUTOS X PROPERTY DAMAGE Per accident $ XXXXXXX HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY Com /Coll Deds. $ 5,000 X PHYS DAM A UMBRELLA LAB X OCCUR N N TH7-691-472101-041 8/1/2021 8/1/2022 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,00 000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ XXXXXXX B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N I A N WCC-691-472101-031 [EXCL. ND, OH, WY, & WA) 8/1/2021 8/1/2021 8/1/2022 8/1/2022 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C CONTRACTOR'S N N EOC 7413240-03 8/1/2021 8/1/2022 POLLUTION: $ 1 M EA CLAIM / POLLUTION AND $2M AGG; PROFESSIONAL: $3M PROFESSIONAL EA CLAIM / $3M AGG; RET: LIABILITY $100K DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) FOR CANCELLATION FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM, THE INSURER(S) WILL SEND 30 DAYS NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER. ADDITIONAL INSURED STATUS (IF SPECIFIED HERE) DOES NOT EXTEND TO PROFESSIONAL LIABILITY COVERAGE. 17963731 CITY OF SANTA ANA RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA 4TH FLOOR SANTA ANA CA 92701 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' - RiskMerwgemenf Dmaion ( RE%AEwm & APPROVED en': 78ze P fcl 19RR 015 ArnRn r( Ri kNtanage tCIen-IAide ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD N