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A-2018-080-01 o ne,evu, �onezom.cav,oaoosotao•
<br />A'C"J?b CERTIFICATE OF LIABILITY INSURANCE
<br />err—•/
<br />FDATE(MMIDDIYYYYI
<br />1 07130Y2020
<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(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 />cuNlAuF Mla Bush
<br />NAME:
<br />Brown & Brown of Florida, Inc.
<br />PHONE 813 226-1337 FAX
<br />A!C No Eat : ( ) A!c No : (813) 226-1313
<br />P.O. Box 173086
<br />mbush bbtam
<br />ADDRESS: a com P
<br />INSURER(S)AFFOROING COVERAGE
<br />NAIC#
<br />Tampa FL 33672
<br />INSURERA; Great Northern Insurance Company
<br />20303
<br />INSURED
<br />INSURER B; Federal Insurance Company
<br />20281
<br />Holland & Knight LLP
<br />IN SURER C: Sentry Insurance a Mutual Company
<br />24988
<br />524 Grand Regency Blvd
<br />INSURER D :
<br />INSURER E:
<br />Brandon FL 33510
<br />INSURER F:
<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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />ILTR
<br />TYPE OF IN SURANCE
<br />INSO
<br />MD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MMIDDIYYYV
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ® OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />MED EXP (Any one person
<br />$ 10,000
<br />A
<br />35798711
<br />08/01/2020
<br />08/01/2021
<br />PERSONAL&ADV INJURY
<br />$ 1,000,000
<br />GENLAGGFEGATE
<br />LIMITAPPLIES PER:
<br />O.
<br />POLICY F—IJECCT FXI LOC
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS-COMPIOPAGG
<br />$ Ind In GA
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />Cold IN GLELIM
<br />Ea accident
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />AWNED SCHAUTOS
<br />AWNS ONLY AUTOS
<br />HIRED NOIJAWNED
<br />AUTOS ONLY X AUrOS ONLY
<br />74966035
<br />08/01/2020
<br />08/01/2021
<br />X
<br />BODILY INJURY Per accident)
<br />$
<br />PROPERr MAGE
<br />Per accident
<br />$
<br />$
<br />B
<br />X
<br />UMBRELLA B
<br />EXCESS LABCL
<br />X
<br />OCCUR
<br />IM&MADE
<br />79818355
<br />08/01/2020
<br />08/01/2021
<br />EACH OCCURRENCE
<br />$ 50,0001000
<br />AGGREGATE
<br />$ 50,000,0 00
<br />DED RETENTION $
<br />$
<br />L.
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETOWPAWNEPJEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />901492301
<br />08/01/2020
<br />08/01/2021
<br />STTATUTE ERH-
<br />E,L. EACHACCICENT
<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 />Personal Properly
<br />Data Proc Equipment
<br />35798711
<br />OB/0112020
<br />08/01/2021
<br />Personal Property
<br />Data Proc Equipment
<br />149,879,125
<br />32,550,000
<br />DESCRIPTION OF OPERATION S / LOCATION S 1 VEHICLES (AC ORD 101, Addltl oral Remarks Schedule, may be allached if more space Is 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
<br />20 Civic Center Plaza 4th Fir AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 e,�"-r, ,. oe e, RAMmtagervrentimbim
<br />pREVIEWED, &MPROvm BY;
<br />61988-2015ACOR
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD I Risk Management Anatyst
<br />
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