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AC(JRa' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 06/03/2021 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 NONE Automatic Data Processing Insurance Agency, Inc. Automatic Data Processing Insurance Agency, Inc. AHJ E : 1-800-524-7024 FAX Nn; E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE _ NAIC # 1 Adp Boulevard Roseland NJ 07068 INSURERA: Trumbull Insurance Company 27120 INSURED ADLERHOR$T INTERNATIONAL LLC INSURERS: INSURER C : INSURER D 3951 Vernon Ave INSURER E : INSURER F : Jurupa Valley CA 925092924 COVERAGES CERTIFICATE NUMBER: 1989503 REVISION NUMBER: 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. Ir�sR TYPE OF INSURANCE ADDLSU6 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER I MM/OD!'/YYY MMIDDIYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE r7l OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL d ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT LQC PRODUCTS • COMPIOP AGG $ OTHER: _ AUTOMOBILE LIABILITY COMBINED SINGLE TMIT Me accident BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PRDPERTYDAMAGE JPer accident $ HARED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ H AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBEREXCLUDED? �N (Mandatory In NH) NIA N 76WEGAL4NDU 0710112021 07/01/2022 STA UTE ER E.L.FACHACCIDENT $ 1,000,000 EL DISEASE- EA EMPLOYEE $ 1,000,000 EL. DISEASE - POLICY LIMIT $ 1,000,000 If es, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is (equired) CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA RISK MANAGEMENT DIVISION 20 CIVIC CENTER PI 7 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 Santa Ana CA 92701 I [015P171; ,1I1R11c[eie1:7111 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Risk Ma ugm ent DMston - o''AN'f'6A REVIEWED & APPROVED BY. o' 'I� Risk Management Analyst