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---qN HOWRGEN-01 jjj�ACCOUNTMANAGER'
<br />A` ORO — pATE1212021
<br />CERTIFICATE OF LIABILITY INSURANCE II 5/12/zgzl
<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 />IMPUKIAN I : IT me canincate nomer Is an AUDnIUNAL INSURED, the pOlICy(IBS) 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 endomement(s).
<br />PRODUCER �C�ONMCT
<br />INSURED
<br />4 Associates
<br />Monica Blvd., Suite 207
<br />PHONE
<br />_ ice. xP E,_.ae);_(310) 478-5041
<br />- - -W
<br />FAX
<br />c, No ;_ 310 479.8707
<br />! (_-------
<br />CA 90025
<br />Mp�
<br />AQORE�aS�
<br />-
<br />__. INSURERLS)AFTnr101NGCOVERAGE_
<br />NAID#
<br />INSURER A: Philadelphia Insurance Companies
<br />23850 -_
<br />INSURER B:ACe American Ins CO
<br />22IN
<br />Howroyd Wright Employment Agency Inc., dba Apple One
<br />ASURERC _..
<br />P.O. Box 29043
<br />Glendale, CA 91209
<br />- INSURER
<br />INSURER E:
<br />_ �— — —
<br />INSURER F:
<br />rn%I=0ArdPS
<br />CERTIFICATE NUMBER:
<br />EVISINUMBER:
<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,
<br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY
<br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />IN R
<br />TYPE OF INSURANCE
<br />AWL SUER POLICY EFF PODGY EXP
<br />D FVVU POLICY NUMBER IMMIppM'VYIfNNxID/YYYY LIMITS
<br />A I X COMMERCIAL GENERAL LIABILITY
<br />�—
<br />EACH OCCURRENCE_ g 3,000,000
<br />CLAIMS MADE OCCUR
<br />_, _
<br />X PHPK2256316 4HI2021 4/112022 FREMSES1O EAcENgUarceJ—t_ 100,000
<br />X I Contractual Liab.
<br />_ 6,000
<br />MED EZP lgpno x v oenon
<br />PERSONAL a ADV INJURY _-� �. 3,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER.
<br />GENERAL_AaQREGATE.It__ 3,000,000
<br />X POLICY WT LI Lee
<br />u
<br />,PRODUCTS-COMPIOPAGG 1 3,000,000
<br />OTHER'
<br />_ S
<br />A AUTOM091LELUIBNTY
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />X ANY AUTO ---
<br />PHPK2256316 411/2021 4/1/2022 BODILY INJURY P enonl_�$
<br />OWNED SCHEDULED
<br />E.pDwUNLEE
<br />_ _
<br />`
<br />AUqr�� ONLY
<br />804ILY INJURY Per accicf It a - — ---
<br />X'�
<br />X �q
<br />A6%ONLY
<br />q
<br />P.09ERTYDAMAGE
<br />PeItleMl.
<br />—AUTOSONLD
<br />r
<br />S
<br />A X UMBRELLALIAB X OCCUR
<br />--
<br />EACH OCCURRENCE 15,000,000
<br />._ }
<br />Excess Lue culMs-MADE
<br />—
<br />-
<br />IPHUB782438 41112021 4I1/2022 AGGREGATE 15,000,000
<br />DED X RETENTION$ 10,000
<br />T$__
<br />$
<br />B WORKERS COMPENSATION
<br />V PER OTH-
<br />ANDEMPLOYERS' LIA61LM YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />�pFIC EXCLUDED?
<br />__SAUTE_ER_
<br />WLRC67816493 4/112021 41112022 y�ggp�ggg
<br />NIA E.L. EAG_H gCCeIQEi{T
<br />In.Iy nB�p
<br />IMendatery m NH)
<br />_
<br />1 000,006
<br />...eL. DISEASE.-pLOYEE.. S
<br />If ea, describe soda
<br />RIPTI OF TIONS below
<br />,,- _ _ _
<br />L.DISE - O YLIMIT 1,000,000
<br />A Crime (3rd Party)
<br />PHSD1619067 4/112021 4/1/2022 OccumancelAggregate 3,000,000
<br />A E&O1Praf. Liability
<br />PHPK2256316 4/112021 41112022 Occumance/Aggregate 3,000,000
<br />DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES
<br />(ACORO 101, Additional Remarks Scnedule, may be .inched H more apace la nxiubaaf)
<br />Job ID 009500724
<br />"Re: City of Santa Ana Agreement No, A-2018-146". The City of Santa Ana, officers, agents, employes and volunteers are named additional insured on this
<br />policy pursuant to written contract, agreement, or memorandum of understanding. Primary and Non -Contributory coverage will apply. Notice of Cancellation
<br />under applicable policies: 30 days/ 10 days
<br />for non-payment of premium.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<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
<br />ACCORDANCE WITH THE POLICY
<br />Risk Management Division
<br />PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701-4010
<br />AUTHORQEDREPRESENTA
<br />�
<br />{,( A -A- RMr MamgeN,dgrNlan
<br />! '�.; f>enOPID6Amrsovm Br J
<br />ACORD 25 (2016103) -
<br />- L _ 01988.20 ACORD CC e, I I : 7Pu %VBTaa.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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