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Digitally signed by Francine R.
<br />Francine R. Villareal Villareal
<br />nara- Xn?i no no nR-n-m -nTnn'
<br />ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DDmYY)
<br />9/8/2021
<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 />Assurance, a Marsh & McLennan Agency LLC company
<br />20 N Martingale Road
<br />Suite 100
<br />CONTACT
<br />NAME: Ann Demos
<br />PHONE FAX
<br />A/C No Ext: (312) 625-5575 A/C, No: (847) 440-9126
<br />ADDE-MRESS: ademos@assuranceagency.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />Schaumburg IL 60173
<br />INSURERA: Philadelphia Indemnity Insuran
<br />18058
<br />INSURED INFOINC-02
<br />INSURERB: Wesco Insurance Company
<br />25011
<br />Infojini, Inc.
<br />10015 Old Columbia Road, Suite B215
<br />INsuRERc: Technology Insurance Company
<br />42376
<br />INSURERD: New York State Insurance Fund
<br />Columbia MD 21046
<br />INSURERE: RSUI Indemnity
<br />22314
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:375633095 REVISION NUMBER:
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />PHPK2240911
<br />2/28/2021
<br />2/28/2022
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />PREMISES DAMAGE TO
<br />ccurrence
<br />PREMISES Ea occurrence)
<br />$ 100,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY PRO ❑ LOC
<br />El JECT
<br />X
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />PHPK2240911
<br />2/28/2021
<br />2/28/2022
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />PROPERTYDAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />A
<br />E
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />PHUB757403
<br />N HA093145
<br />2/28/2021
<br />2/28/2021
<br />2/28/2022
<br />2/28/2022
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />X
<br />AGGREGATE
<br />$ 10,000,000
<br />DED X RETENTION $ 1 n nnn
<br />Excess Liability
<br />$ Limit: 5,000,000
<br />C
<br />B
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNEPJEXECUTIVE N
<br />TWC3962244 & NV Only)2/28/2021
<br />(CO(
<br />WWC3522105
<br />25095316 (NY Only)
<br />2/28/2021
<br />2/28/2021
<br />2/28/2022
<br />2/28/2022
<br />2/28/2022
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED?
<br />N /A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Crime (Loss of Client's Property)
<br />PHSD1610519
<br />2/28/2021
<br />2/28/2022
<br />Agg: 5,000,000
<br />OCC: 5,000,000
<br />A
<br />A
<br />Employment Practices Liability
<br />Professional Liability
<br />PHSD1610519
<br />PHPK2240911
<br />2/28/2021
<br />2/28/2021
<br />2/28/2022
<br />2/28/2022
<br />Agg: 3,000,000
<br />Agg: 2,000,000
<br />Occ: 3,000,000
<br />OCC: 1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Workers Compensation and Employers' Liability: Any Proprietor/Partner/Executive Officer/Member, as listed on the policy, is excluded.
<br />Excess Liability Policy #NHA093145 provides a limit of $5 Million over the Primary Umbrella Limit of $10 Million
<br />Cyber - 660760701 - Effective 2/28/2021 - 2/28/2022 - Aggregate: $1,000,000 - HSB Specialty Insurance Company
<br />Tech E&O-PHPK2240891- Effective 2/28/2021 - 2/28/2022- Each Claim Limit: $10,000,000- Aggregate: $10,000,000- Philadelphia Indemnity Insurance
<br />Company
<br />Network Security Privacy Injury-PHPK2240891- Effective 2/28/2021 - 2/28/2022- Each Claim Limit: $10,000,000- Aggregate: $10,000,000
<br />See Attached...
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF,
<br />NOTICE WILL
<br />BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />RisieMallagementDiviaian
<br />�,�oRaN�
<br />REVIEWED & APPROVED BY:
<br />© 1988-2015 ACORD C
<br />z
<br />°I G`
<br />pu-c-;" P, (JSA44a
<br />ACORD 25 (2016/03)
<br />The ACORD name and logo are registered marks of ACORD
<br />l
<br />'
<br />Risk Management Analyst
<br />
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