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Francine R. Digitally signed by Francine R.
<br />Villareal
<br />Villareal Date: 2021.04.07 11:51:13
<br />-07'00'
<br />ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />1
<br />16.�
<br />03/30/2021
<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 />Baker, Romero & Associates Insurance Brokers, InC.
<br />CONTACT Christine R Sousa
<br />750 Terrado Plaza #238('C'
<br />PHONE FAX
<br />A/c No E:t : (626)332-2258 ,C No): (626)339-9921
<br />aDDRESS: christine@bakerromero.com
<br />Covina, CA 91723
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />License #: OG22790
<br />INSURERA: TRAVELERS PROPERTY CASUALTY CO. OFAMERICA
<br />25674
<br />INSURED Galvin Preservation Associates Inc.
<br />INSURERB: State Compensation Insurance Fund
<br />NR
<br />INSURER C: Continental Casualty Co
<br />20443
<br />DBA GPA Consulting
<br />201 Nevada Street, Suite B
<br />INSURERD: Continental Casualty Co.
<br />20443
<br />El Segundo, CA 90245
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 00002920-14811515 REVISION NUMBER: 844
<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 />I NSR
<br />LTR
<br />OF INSURANCE
<br />ADDLSUBRTYPE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />EFF
<br />MM DD/YYYY
<br />POLICYPOLICY
<br />MMDD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />680-4H777478-21-47
<br />03/14/2021
<br />03/14/2022
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 11000,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L
<br />POLICY X PE0. LOC
<br />PRODUCTS- COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />BA-4R690875-21-47-G
<br />03/14/2021
<br />03/14/2022
<br />COMBINED
<br />(Ea acccidentSINGLE LIMIT
<br />$ 11000000
<br />BODILY INJURY(Per person)
<br />$
<br />ANY AUTO
<br />Ix
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY(Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY X AUTOS ONLY
<br />A
<br />X
<br />UMBRELLA LIAB
<br />OCCUR
<br />Y
<br />Y
<br />CUP-OJ605520-21-47
<br />03/14/2021
<br />03/14/2022
<br />EACH OCCURRENCE
<br />$ 7,000,000
<br />AGGREGATE
<br />$ 7,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />X
<br />DED RETENTION$ 10000
<br />Prod/Co Ops
<br />$ 7,000,000
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
<br />Y
<br />9114062-2021
<br />03/14/2021
<br />03/14/2022
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />(Mandatory in NH)
<br />NIA
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />C
<br />Prof. Liab. $15K Ded
<br />EEH288371840
<br />03/14/2021
<br />03/14/2022
<br />$5M Per Claim
<br />retro: 3/20/12
<br />D
<br />Pollution, $15K Ded
<br />EEH288371840
<br />03/14/2021
<br />03/14/2022
<br />Aggregate
<br />$5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />A.M. Best Ratings: Travelers Property Casualty Company of America (A++ XV); Continental Casualty Company (A XV); State
<br />Compensation Insurance Fund (Not Rated) The City of Santa Ana, its officers, employees, agents and representatives are named
<br />as additional insured on this policy pursuant to written contract, agreement, or memorandum of understanding. The insurance
<br />coverage shall be primary insurance as respects the CITY, tts officers, employees, agents and representatives The following
<br />blanket forms apply to the Additional Insured attached herewith:
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br />© 1988-2016 ACORD COF Risk MmRgmerdDivisian
<br />3 r REVIEWED & APPROVED BY.-
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />Printed by C 's3rei-l--r�1G; rs.G+ v.
<br />ice',
<br />��� Risk Management Analyst
<br />
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